Parents continue practice that increases SIDS risk

“Studies that measure trends in infant care practices are helpful in providing a window into our patients’ behaviors and guiding us as we provide education on a public as well as individual level. The article by Shapiro-Mendoza and colleagues is the first to report trends in the use of potentially hazardous bedding in the infant sleep environment.

“There were several disturbing findings described in the study. Of course, the next question for us to ask is, Why do parents feel the need to use soft bedding? Qualitative studies are helpful in this regard. The major reasons for using soft bedding are comfort/warmth and safety. Many parents worry that their infant will become cold or otherwise be uncomfortable if they do not use bedding.

“In addition, parents may be incorrectly interpreting the recommendation against using thick blankets or comforters as meaning only over the infant, rather than under as well. Ironically, parents believe that soft bedding makes the sleep area safer for their infant. Unfortunately, if infants roll into these objects, they may not be able to roll back out and may accidentally suffocate.

“The groups at highest risk of SIDS are also those that were found in this study to be more likely to be using potentially hazardous bedding in their infants’ sleep environment: teenage, black, or less-educated mothers. Counseling is likely more effective if we understand parental concerns and misgivings about infant health and safety recommendations and can address these. Discussion of potentially hazardous bedding should be included whenever we talk to parents about the infant’s sleep environment and safe sleep practices. Only then will we be able to achieve improvements in these worrisome trends and further reductions in the incidence of SIDS and suffocation deaths.”

Dr. Rachel Y. Moon is at the Goldberg Center for Community Pediatric Health at Children’s National Medical Center in Washington and George Washington University. Dr. Fern R. Hauck is a professor of family medicine at University of Virginia in Charlottesville. These comments are from an editorial accompanying the study. Both authors reported no disclosures.