Objective: To identify parental characteristics associated with infants being placed to sleep in the prone position.
Study design: Cross-sectional survey.
Patients: Randomly selected King County, Washington, infants born on the same days as King County infants who died of sudden infant death syndrome between November 1992 and October 1994.
Methods: Parents of study infants responded to a telephone interview about sleep position in their infants. Parents were asked how they usually put their infants to bed during the previous 2 weeks, and if they were aware of any recent advice on sleep position in young infants. Demographic data were also collected during the telephone interview. Logistic regression was used to identify infant and parental characteristics associated with the prone sleep position.
Results: Parents of 178 infants were interviewed; 28.1% responded that their infants usually slept prone, 66.9% slept nonprone, and 5% had no usual sleep position. Parents who were unaware of sleep position advice were more likely to place their infants prone than those who were aware of this advice (odds ratio, 3.5; 95% confidence interval, 1.5-7.8). Among parents who were aware of sleep position advice, mothers younger than 20 years were more than 10 times as likely to place their infants prone than were older mothers (odds ratio, 10.7; 95% confidence interval, 1.1-107.0). For those who were unaware of sleep position advice, single mothers were more likely to place their infants prone (odds ratio, 14.0; 95% confidence interval, 1.5-133.2). Single mothers and parents of low-birth-weight infants were more likely to be unaware of recent medical advice regarding optimal sleep position for infants.
Conclusions: 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 position. Single mothers should be targeted for intensive educational efforts regarding the hazards of prone sleeping. Among teenage mothers, awareness of the association between prone sleeping and sudden infant death syndrome may not be adequate to change behavior; educational interventions that are more focused for this age group may be needed.