104 - Understanding Parental Behaviours Related to Infant Sleep Environment.
Friday, April 28, 2023
5:15 PM – 7:15 PM ET
Poster Number: 104 Publication Number: 104.15
Michelle Shouldice, The Hospital for Sick Children, Toronto, ON, Canada; Jennifer N.. Smith, The Hospital for Sick Children, Toronto, ON, Canada; Sanjay Mahant, University of Toronto Temerty Faculty of Medicine, toronto, ON, Canada; Julie C. Johnstone, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
Division Head, Paediatric Medicine The Hospital for Sick Children Toronto, Ontario, Canada
Background: Sudden unexplained death in infants continues to make up a significant proportion of infant deaths. Despite wide dissemination of Canadian Pediatric Society and American Academy of Pediatrics safe sleep recommendations, studies demonstrate significant caregiver nonadherence to the recommendations. Few studies have examined caregiver reasons for low uptake of recommendations. There is an urgent need to understand these issues not only for individual providers counselling about sleep, but also for implementation of public health initiatives which attempt to target parental behaviour change. Objective: Our study aimed to explore parental perceptions, beliefs and influences regarding safe infant sleep environment and factors contributing to parental behaviour related to sleep environment. Design/Methods: A qualitative study utilizing ground theory methodology was conducted with in-depth individual interviews of 14 parents of infants less than six months admitted to a large pediatric hospital in Toronto, Canada. Data collection occurred from November 2017 to January 2018 until a saturation of themes was reached. Interview transcripts were analyzed for recurrent and emergent themes and a coding structure was developed. Results: Interviews with caregivers were completed, and a range of sleep locations and environments were described. Most caregivers reported that a bassinet or crib was the main sleeping location, but most infants were also placed in other locations at various times, including infant swings, couches, and bed-sharing with caregivers. Three dominant themes affecting decision-making about sleep location were identified: 1. safety, 2. feasibility and convenience and, 3. perception of infant preference and developmental needs. These factors were often present simultaneously in parental decision-making and frequently acting in opposition to one another. Caregivers’ methods of mitigating harm were often counter to recommendations, such as using pillows to prevent rolling. Information sources regarding sleep choices typically included family, friends, healthcare providers and media. Most caregivers placed greater significance on healthcare recommendations than the advice of family members.
Conclusion(s): This study identified key factors that impact caregivers’ decision-making regarding infant sleep. These results can inform healthcare providers counselling about safe sleep recommendations and public health interventions aimed at increasing adherence to safe sleep recommendations and reducing preventable infant deaths.
