Teen moms and infant sleep: Mother doesn't always know best

Sudden unexpected infant death (SUID), which includes sudden infant death syndrome (SIDS), is the leading cause of death in infants 1 month to 1 year of age in the United States. Although the reason is unknown, maternal age less than 20 years is associated with an increased risk of SIDS. In a new study scheduled for publication in The Journal of Pediatrics, researchers found that although teenage mothers know the recommendations in regards to safe sleeping practices, many deliberately do not follow those recommendations.

Dr. Michelle Caraballo and researchers from the University of Colorado and Children's Hospital Colorado recruited 43 teenage mothers from high school daycare centers throughout Colorado to participate in seven focus groups about safe sleep for their infants (2-21 months of age). According to Dr. Caraballo, "We sought to understand participants' information sources and factors motivating decision-making about their infants' sleep practices."

Most of the teenage mothers were familiar with SIDS and the recommendations against co-sleeping and the use of blankets and pillows in the baby's sleeping area. Despite this, co-sleeping and the use of soft bedding, especially blankets, were extremely common. The most prevalent reasons given for co-sleeping were the perception that babies seemed to sleep better and were safest in bed with them; many mothers used blankets because they were concerned that babies would be cold and they thought that babies are more comfortable with blankets. All of the teenage mothers believed that their instincts were more accurate than anyone else's, even when those instincts are in direct contradiction to expert advice and safe sleep recommendations.

Although first time mothers typically feel timid and uncertain, the teenage mothers in the focus groups displayed an almost cavalier confidence in their ability to decide the right thing to do regarding sleep practices. "We learned that almost all teenage mothers were already aware of the recommendations," notes Dr. Caraballo, "yet they were making deliberate decisions to practice unsafe behaviors." New approaches, including making sure healthcare providers are providing accurate, consistent information and innovative public service announcements targeting teenage mothers, should be considered to improve safe sleep behaviors in this high-risk group.