Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 153 (5), 512-7

Prone Infant Sleeping Despite the "Back to Sleep" Campaign


Prone Infant Sleeping Despite the "Back to Sleep" Campaign

M C Ottolini et al. Arch Pediatr Adolesc Med.


Objectives: To determine sleep position variation during the first 6 months of life and to identify risk factors for prone sleeping.

Design: Cohort study of healthy term newborns recruited from November 1995 to September 1996 and followed up to age 6 months. Pediatricians were surveyed about sleep position advice. At recruitment, all parents were instructed to avoid prone sleeping. Parents were telephoned at 1 week and then monthly to ensure that they recorded sleep position. Investigators were unaware of sleep position until the infant was 6 months of age, when sleep log data and reasons for sleep position choice were ascertained.

Setting: Practice-based study conducted by the Children's National Medical Center Pediatric Research Network, Washington, DC.

Participants: A total of 402 consecutive healthy term newborns followed up by a Pediatric Research Network pediatrician were enrolled. Exclusion criteria were prematurity, a serious medical condition, and absence of a telephone. Of the 402 enrolled newborns, 348 (86.6%) completed the study.

Results: Only 34.0% of infants maintained a consistent sleep position. Prone sleeping increased from 12.2% at birth to 32.0% at 6 months. One third of pediatricians discussed sleep position beyond the newborn period. The following were associated (P<.05) with prone sleeping: male sex, lower maternal education level, single marital status, having siblings, and black race. Perceived infant comfort was the main reason for prone sleeping.

Conclusions: Most newborns are placed by parents in nonprone sleep positions. Pediatricians need to consistently reinforce the "Back to Sleep" message when the infants are 2 to 4 months of age because this is the most likely time that they are switched to prone sleeping and the highest risk period of sudden infant death syndrome. Parents should not use prone sleeping as a means of comforting infants.

Similar articles

  • Determinants of Infant Sleep Position in an Urban Population
    RY Moon et al. Clin Pediatr (Phila) 41 (8), 569-73. PMID 12403373.
    The incidence of SIDS has decreased by 40% since the Back to Sleep campaign was initiated. However, the rate of SIDS in the District of Columbia continues to be approxima …
  • Sleep Position of Low Birth Weight Infants
    L Vernacchio et al. Pediatrics 111 (3), 633-40. PMID 12612248.
    Prone sleep decreased among low birth weight infants from 1995 to 1998. However, VLBW infants, who are at very high risk for sudden infant death syndrome, are more likely …
  • Risk Factors for the Infant Prone Sleep Position
    JA Taylor et al. Arch Pediatr Adolesc Med 150 (8), 834-7. PMID 8704890.
    The results of this study may provide direction to future efforts to encourage nonprone sleeping. Knowledge of the risk is associated with decreased use of prone sleep po …
  • [A Review of Recent Studies Investigating the Relationship Between Sudden Infant Death Syndrome and Sleeping Position]
    M Funayama. Nihon Hoigaku Zasshi 48 (6), 439-51. PMID 7861642. - Review
    Recent references (articles and letters) investigating relationship between sudden infant death syndrome (SIDS) and sleeping position are presented. There are many articl …
  • [Sleeping Position for Preterm Infants]
    CF Poets et al. Z Geburtshilfe Neonatol 212 (1), 27-9. PMID 18293260. - Review
    Supine sleeping is recommended to prevent the sudden infant death syndrome (SIDS). Low birth weight infants are at increased risk for SIDS, which is increased further if …
See all similar articles

Cited by 13 PubMed Central articles

See all "Cited by" articles