Sleep practices often less safe after infant nighttime waking

Few parents with infants aged 12 months or younger report adhering to all three recommended safe sleep practices at sleep onset and after nighttime waking, with many changes in sleep practices to less-safe practices, according to a study published online May 30 in Pediatrics.

Mersine A. Bryan, M.D., M.P.H., from the University of Washington in Seattle, and colleagues conducted a cross-sectional online survey of parents with infants aged 12 months and younger to assess parent-reported sleep practices. A composite score examined whether all three safe sleep practices were used at sleep onset and after nighttime waking; safe sleep was defined as supine position, sleeping in a separate space, and sleeping in a crib, bassinet, cradle, or play yard.

The researchers found that 39 percent of the 1,500 participants reported a second-sleep practice. Of those reporting a second-sleep practice, 28 and 9 percent met all three safe sleep criteria at sleep onset and at both time points, respectively. Significantly more changes in sleep practices were to less-safe practices. Parental age younger than 25 years, parental race and ethnicity, first-time parents, homes with smoke exposure, and infants born at less than 37 weeks were factors associated with second-sleep practices.

"Importantly, a significantly higher proportion of changes were to a less-safe sleep practice (e.g., supine to prone)," the authors write. "Less than 10 percent of our sample reported adhering to all three recommended infant safe sleep practices at both sleep onset and after nighttime waking."

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