Skip to main content

Advertisement

SpringerLink
Log in

Infant Safe Sleep Interventions, 1990–2015: A Review

  • Review
  • Published:
Journal of Community Health Aims and scope Submit manuscript

Abstract

Sleep-related infant deaths remain a major public health issue. Multiple interventions have been implemented in efforts to increase adherence to safe sleep recommendations. We conducted a systematic review of the international research literature to synthesize research on interventions to reduce the risk of sleep-related deaths and their effectiveness in changing infant sleep practices. We searched PubMed, CINAHL, PsycINFO, and Google Scholar for peer-reviewed articles published between 1990 and 2015 which described an intervention and reported results. Twenty-nine articles were included for review. Studies focused on infant caregivers, health care professionals, peers, and child care professionals. Targeted behaviors included sleep position, location, removing items from the crib, breastfeeding, smoke exposure, clothing, pacifier use, and knowledge of Sudden Infant Death Syndrome. Most articles described multi-faceted interventions, including: one-on-one or group education, printed materials, visual displays, videos, and providing resources such as cribs, pacifiers, wearable blankets, and infant t-shirts. Two described public education campaigns, one used an educative questionnaire, and one encouraged maternal note taking. Health professional interventions included implementing safe sleep policies, in-service training, printed provider materials, eliciting agreement on a Declaration of Safe Sleep Practice, and sharing adherence data. Data collection methods included self-report via surveys and observational crib audits. Over half of the studies utilized comparison groups which helped determine effectiveness. Most articles reported some degree of success in changing some of the targeted behaviors; no studies reported complete adherence to recommendations. Future studies should incorporate rigorous evaluation plans, utilize comparison groups, and collect demographic and collect follow-up data.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Heron, M. (2013). Deaths: Leading causes for 2010. National Vital Statistics Reports, 62(6), 1–69.

    PubMed  Google Scholar 

  2. Carlberg, M. M., Shapiro-Mendoza, C. K., & Goodman, M. (2012). Maternal and infant characteristics associated with accidental suffocation and strangulation in bed in US infants. Maternal and Child Health Journal, 16(8), 1594–1601.

    Article  PubMed  Google Scholar 

  3. American Academy of Pediatrics. (2011). SIDS and other sleep-related infant deaths: Expansion of recommendations for a safe infant sleeping environment. Pediatrics, 128(5), 1030–1039.

    Article  Google Scholar 

  4. American Academy of Pediatrics. (1992). Positioning and SIDS. Pediatrics, 39, 1120–1126.

    Google Scholar 

  5. American Academy of Pediatrics. (1997). Does bed sharing affect the risk of SIDS? Pediatrics, 100(2), 272.

    Article  Google Scholar 

  6. American Academy of Pediatrics. (2000). Changing concepts of Sudden Infant Death Syndrome: Implications for infant sleeping environment and sleep position. Pediatrics, 105, 650–656.

    Article  Google Scholar 

  7. American Academy of Pediatrics. (2005). The changing concept of Sudden Infant Death Syndrome (SIDS): Diagnostic coding shifts, controversies regarding the sleeping environment, and new variables to consider in reducing risk. Pediatrics, 116(5), 1245–1255.

    Article  Google Scholar 

  8. Bryanton, J., Beck, C. T., & Montelpare, W. (2013). Postnatal parental education for optimizing infant general health and parent–infant relationships. Cochrane Database Systematic Review, 11, 1–90.

    Google Scholar 

  9. Goetter, M. C., & Flanders Stepans, M. B. (2005). First-time mothers’ selection of infant supine sleep positioning. Journal of Perinatal Education, 14(4), 16–23.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Issler, R. M., Marostica, P. J., & Giugliani, E. R. (2009). Infant sleep position: A randomized clinical trial of an educational intervention in the maternity ward in Porto Alegre, Brazil. Birth, 36(2), 115–121.

    Article  PubMed  Google Scholar 

  11. Popay, J., Roberts, H., Sowden, A., et al. (2006). Guidance on the conduct of narrative synthesis in systematic reviews: A product from the ESRC methods programme. Lancaster: Institute for Health Research, University Lancaster.

    Google Scholar 

  12. Ahlers-Schmidt, C. R., Schunn, C., Nguyen, M., Nimeskern-Miller, J., Rabea Ilahe, R., & Kuhlmann, S. (2015). Does providing infant caregivers with a wearable blanket increase safe sleep practices? A randomized controlled trial. Clinical Pediatrics. doi:10.1177/0009922815572077.

    PubMed  Google Scholar 

  13. Ahlers-Schmidt, C. R., Schunn, C., Dempsy, M., & Blackon, S. (2014). Evaluation of community baby showers to promote safe sleep. Kansas Journal of Medicine, 7, 1–5.

    Google Scholar 

  14. Ahlers-Schmidt, C. R., Kuhlmann, S., Kuchlmann, Z., Schunn, C., & Rosell, J. (2014). To improve safe-sleep practices, more emphasis should be placed on removing unsafe items from the crib. Clinical Pediatrics, 53(13), 1285–1287.

    Article  PubMed  Google Scholar 

  15. Canter, J., Rao, V., Patrick, P. A., Alpan, G., & Altman, R. L. (2015). The impact of a hospital-based educational video on maternal perceptions and planned practices of infant safe sleep. Journal for Specialists in Pediatric Nursing. doi:10.1111/jspn.12114.

    PubMed  Google Scholar 

  16. Carlins, E. M., & Collins, K. S. (2007). Cribs for Kids: Risk and reduction of Sudden Infant Death Syndrome and accidental suffocation. Health and Social Work, 32(3), 225–229.

    Article  PubMed  Google Scholar 

  17. Gelfer, P., Cameron, R., Masters, K., & Kennedy, K. A. (2013). Integrating “back to sleep” recommendations into neonatal ICU practice. Pediatrics, 131(4), e1264–e1270.

    Article  PubMed  Google Scholar 

  18. Hauck, F. R., Tanabe, K. O., McMurry, T., & Moon, R. Y. (2015). Evaluation of Bedtime Basics for Babies: A national crib distribution program to reduce the risk of sleep-related sudden infant deaths. Journal of Community Health, 40(3), 457–463. doi:10.1007/s10900-014-9957-0.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Mason, B., Ahlers-Schmidt, C. R., & Schunn, C. (2013). Improving safe sleep environments for well newborns in the hospital setting. Clinical Pediatrics, 52(10), 969–975.

    Article  PubMed  Google Scholar 

  20. McMullen, S. L., Lipke, B., & LeMura, C. (2009). Sudden Infant Death Syndrome prevention: A model program for NICUs. Neonatal Network, 28(1), 7–12.

    Article  PubMed  Google Scholar 

  21. Moon, R. Y., Oden, R. P., & Grady, K. C. (2004). Back to sleep: Educational intervention with women, infants, and children program clients. Pediatrics, 113(3), 542–547.

    Article  PubMed  Google Scholar 

  22. Moon, R. Y., Calabrese, T., & Aird, L. (2008). Reducing the risk of Sudden Infant Death Syndrome in child care and changing provider practices: Lessons learned from a demonstration project. Pediatrics, 122, 788–798.

    Article  PubMed  Google Scholar 

  23. Price, S. K., Gardner, P., Hillman, L., Schenk, K., & Warren, C. (2008). Changing hospital newborn nursery practice: Results from a statewide “Back to Sleep” nurses training program. Maternal and Child Health Journal, 12(3), 363–371.

    Article  PubMed  Google Scholar 

  24. Rasinski, K. A., Kuby, A., Bzdusek, S. A., Silvestri, J. M., & Weese-Mayer, D. E. (2003). Effect of a Sudden Infant Death Syndrome risk reduction education program on risk factor compliance and information sources in primarily black urban communities. Pediatrics, 111(4), e347–e354.

    Article  PubMed  Google Scholar 

  25. Shaefer, S. J., Herman, S. E., Frank, S. J., Adkins, M., & Terhaar, M. (2010). Translating infant safe sleep evidence into nursing practice. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 39(6), 618–626.

    Article  PubMed  Google Scholar 

  26. Srivasta, B., Eden, A. N., & Mir, M. A. (1999). Infant sleep position and SIDS: A hospital-based interventional study. Journal of Urban Health, 76(3), 314–321.

    Article  Google Scholar 

  27. Voos, K. C., Terreros, A., Larimore, P., Leick-Rude, M. K., & Park, N. (2014). Implementing safe sleep practices in a neonatal intensive care unit. The Journal of Maternal-Fetal Neonatal Medicine. doi:10.3109/14767058.2014.964679.

    PubMed  Google Scholar 

  28. Kistin, C. J., Barrero-Castillero, A., Lewis, S., et al. (2012). Maternal note-taking and infant care: A pilot randomised controlled trial. Archives of Disease in Childhood, 97(10), 916–918.

    Article  PubMed  Google Scholar 

  29. Colson, E. R., & Joslin, S. C. (2002). Changing nursery practice gets inner-city infants in the supine position for sleep. Archives of Pediatric Adolescent Medicine, 156(7), 717–720.

    Article  Google Scholar 

  30. Burd, L., Peterson, M., Face, G. C., Face, F. C., Shervold, D., & Klug, M. G. (2007). Efficacy of a SIDS risk factor education methodology at a Native American and Caucasian site. Maternal and Child Health Journal, 11(4), 365–371.

    Article  PubMed  Google Scholar 

  31. Goodstein, M. H., Bell, T., & Krugman, S. D. (2015). Improving infant sleep safety through a comprehensive hospital-based program. Clinical Pediatrics, 54(3), 212–221.

    Article  PubMed  Google Scholar 

  32. Barnes-Josiah, D. L., Eurek, P., Huffman, S., Heusinkvelt, J., Severe-Oforah, J., & Schwalberg, R. (2007). Effect of “This side up” T-shirts on infant sleep position. Maternal and Child Health Journal, 11(1), 45–48.

    Article  PubMed  Google Scholar 

  33. Cowan, S., Pease, A., & Bennett, S. (2013). Usage and impact of an online education tool for preventing sudden unexpected death in infancy. Journal of Paediatric and Child Health, 49(3), 228–232.

    Article  Google Scholar 

  34. D’Halluin, A. R., Roussey, M., Branger, B., Venisse, A., & Pladys, P. (2011). Formative evaluation to improve prevention of Sudden Infant Death Syndrome (SIDS): A prospective study. Acta Paediatrica, 100(10), e147–e151.

    Article  PubMed  Google Scholar 

  35. Markestad, T., Skadberg, B., Hordvik, E., Morild, I., & Irgens, L. M. (1995). Sleeping position and Sudden Infant Death Syndrome (SIDS): Effect of an intervention programme to avoid prone sleeping. Acta Paediatrica, 84, 375–378.

    Article  PubMed  CAS  Google Scholar 

  36. Mehanni, M., Kiberb, B., McDonnell, M., O’Regan, M., & Mathews, T. (1999). Reduce the risk of cot death guidelines. The effect of a revised intervention programme. National Sudden Infant Death Register, Dublin. Irish Medical Journal, 92(2), 266–269.

    PubMed  CAS  Google Scholar 

  37. Young, J., & O’Rourke, P. (2003). Improving attitudes and practices relating to sudden infant death syndrome and the reduce the risk messages: The effectiveness of an educational intervention in a group of nurses and midwives. Neonatal, Paediatric and Child Health Nursing, 6(2), 4–14.

    Google Scholar 

  38. Hesselink, A. E., van Poppel, M. N., van Eijsden, M., Twisk, J. J., & van der Wal, M. F. (2012). The effectiveness of a perinatal education programme on smoking, infant care, and psychosocial health for ethnic Turkish women. Midwifery, 28(3), 306–313.

    Article  PubMed  Google Scholar 

  39. Hooker, E., Ball, H. L., & Kelly, P. J. (2001). Sleeping like a baby: Attitudes and experiences of bedsharing in Northeast England. Medical Anthropology, 19(3), 203–222.

    Article  PubMed  CAS  Google Scholar 

  40. Board on Neuroscience and Behavioral Health, Committee on Communication for Behavior Change in the 21st Century: Improving the Health of Diverse Populations, Institute of Medicine. (2002). Speaking of health: Assessing health communication strategies for diverse populations. Washington: National Academies Press.

  41. Ball, H. L., & Volpe, L. E. (2013). Sudden Infant Death Syndrome (SIDS) risk reduction and infant sleep location—Moving the discussion forward. Social Science and Medicine, 79, 84–91.

    Article  PubMed  Google Scholar 

  42. Kendall-Tackett, K., Cong, Z., & Hale, T. W. (2010). Mother–infant sleep locations and nighttime feeding behavior: US data from the survey of mothers’ sleep and fatigue. Clinical Lactation, 1, 27–31.

    Article  Google Scholar 

  43. Gurbutt, D., & Gurbutt, R. (2007). Risk reduction and Sudden Infant Death Syndrome. Community Practitioner, 80(1), 24–27.

    PubMed  Google Scholar 

  44. Gaydos, L. M., Blake, S. C., Gazmararian, J. A., Woodruff, W., Thompson, W. W., & Dalmida, S. G. (2015). Revisiting safe sleep recommendations for African–American infants: Why current counseling is insufficient. Maternal and Child Health Journal, 19(3), 496–503.

    Article  PubMed  Google Scholar 

  45. Chianese, J., Ploof, D., Trovato, C., & Chang, J. C. (2009). Inner-city caregivers’ perspectives on bed sharing with their infants. Academic Pediatrics, 9(1), 26–32.

    Article  PubMed  Google Scholar 

  46. Baddock, S. A., Galland, B. C., Taylor, B. J., & Bolton, D. P. (2007). Sleep arrangements and behavior of bed-sharing families in the home setting. Pediatrics, 119(1), e200–e207.

    Article  PubMed  Google Scholar 

  47. Baddock, S. (2005). Infant bed-sharing vs cot-sleeping in the home environment. Junctures, 5, 47–53.

    Google Scholar 

  48. Ball, H. L. (2006). Parent–infant bed-sharing behaviour: Effects of feeding type, and presence of father. Human Nature, 17(3), 303–318.

    Article  Google Scholar 

  49. Philbrook, L. E., Hozella, A. C., Kim, B. R., Jian, N., Shimizu, M., & Teti, D. M. (2014). Maternal emotional availability at bedtime and infant cortisol at 1 and 3 months. Early Human Development, 90(10), 595–605.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  50. Teti, D. M., Bo-Ram, K., Mayer, G., & Countermine, M. (2010). Maternal emotional availability at bedtime predicts infant sleep quality. Journal of Family Psychology, 24(3), 307–315.

    Article  PubMed  Google Scholar 

  51. Teti, D. M., & Crosby, B. (2012). Maternal depressive symptoms, dysfunctional cognitions, and infant night waking: The role of maternal nighttime behavior. Child Development, 83(3), 939–953.

    Article  PubMed  Google Scholar 

  52. Gray, K. (2008). Franklin county infant safe sleep and SIDS risk reduction hospital-based initiative. NACCHO Exchange, 7(4), 12–14. http://www.naccho.org/topics/modelpractices/

  53. Shaefer, J., & Bronheim, S. (2007b). Keeping the faith: Alameda County, CA. Promising practices for cultural and linguistic competence in addressing Sudden Infant Death Syndrome and other infant death. http://nccc.georgetown.edu/documents/SIDS_california.pdf

  54. Shaefer, J., & Bronheim, S. (2007a). Dialogue creates effective risk reduction training: North Carolina. Promising practices for cultural and linguistic competence in addressing Sudden Infant Death Syndrome and other infant death. http://nccc.georgetown.edu/documents/SIDS_northcarolina.pdf

  55. Shaefer, J., & Bronheim, S. (2007c). With always right, teens get the message: New York City, NY. Promising practices for cultural and linguistic competence in addressing Sudden Infant Death Syndrome and other infant death. http://nccc.georgetown.edu/documents/SIDS_newyork.pdf

  56. Smith, M. R., & Pliska, E. (2013). Arkansas’ grassroots effort to reduce infant mortality among African–Americans. Association of State and Territorial Health Officials. http://www.astho.org/Arkansas-Grassroots-Efforts-to-Reduce-Infant-Mortality/

Download references

Author information

Authors and Affiliations

  1. School of Social Work, University of Georgia, 279 Williams Street, Athens, GA, 30605, USA

    Trina C. Salm Ward & Giselle M. Balfour

  2. Health Promotion and Behavior, College of Public Health, University of Georgia, Athens, GA, USA

    Trina C. Salm Ward

Authors
  1. Trina C. Salm Ward
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Giselle M. Balfour
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Trina C. Salm Ward.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Salm Ward, T.C., Balfour, G.M. Infant Safe Sleep Interventions, 1990–2015: A Review. J Community Health 41, 180–196 (2016). https://doi.org/10.1007/s10900-015-0060-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10900-015-0060-y

Keywords

Search

Navigation