Safe sleep, day and night: mothers' experiences regarding infant sleep safety

Annie Lau; Wendy Hall

doi:10.1111/jocn.13322

Improving infant sleep safety via electronic health record communication: a randomized controlled trial

BMC Pediatrics ◽

10.1186/s12887-020-02369-2 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Ethan A. Canty ◽

Benjamin N. Fogel ◽

Erich K. Batra ◽

Eric W. Schaefer ◽

Jessica S. Beiler ◽

...

Keyword(s):

Electronic Health Record ◽

Controlled Trial ◽

Intervention Group ◽

Health Record ◽

Patient Portal ◽

Infant Sleep ◽

Patient Portals ◽

Safe Sleep ◽

Electronic Health ◽

Sleep Safety

Abstract Background With increased use of telehealth, interventions to improve infant sleep environments have not been explored. This study sought to assess the feasibility and efficacy of using electronic health record patient portals to transmit photographs of infant sleep between mothers and healthcare professionals as part of an intervention to promote sleep environments consistent with AAP guidelines. Methods One hundred eighty-four mother-newborn dyads consented to participate in a randomized trial requiring patient portal registration within 1 month of delivery. We first assessed feasibility as measured by a) the proportion of consented mothers enrolling in the portal and b) maternal adherence to prompts to submit photographs of their infant sleeping to the research team through the patient portal. Intervention group mothers were prompted at 1 and 2 months; controls were prompted only at 2 months. Efficacy was determined via research assistant review of submitted photographs. These assistants were trained to detect sudden unexplained infant death risk factors utilizing AAP guidelines. Standardized feedback was returned to mothers through the patient portal. We used Fisher’s Exact test to assess group differences in guideline adherence at 2 months. Results One hundred nine mothers (59%) enrolled in the patient portal and were randomized to intervention (N = 55) and control (N = 54) groups. 21 (38, 95% CI 25–52%) intervention group participants sent photographs at 1 month and received personalized feedback. Across both groups at 2 months, 40 (37, 95% CI 28–46%) sent photographs; 56% of intervention group participants who submitted photographs met all safe sleep criteria compared with 46% of controls (difference 0.10, 95% CI − 0.26 to 0.46, p = .75). Common reasons for guideline non-adherence were sleeping in a room without a caregiver (43%), loose bedding (15%) and objects (8%) on the sleep surface. Conclusions Utilizing the patient portal to individualize safe infant sleep is possible, however, we encountered numerous barriers in this trial to assess its effects on promoting safe infant sleep. Photographs of infants sleeping showed substantial non-adherence to AAP guidelines, suggesting further needs for improvement to promote safe infant sleep practices. Trial registration Name: Improving Infant Sleep Safety With the Electronic Health Record; Clinicaltrials.gov: NCT03662048; Date of Registration: September 7, 2018; Data Sharing Statement: None

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Field assessment of a safe sleep instrument using smartphone technology

Journal of Clinical and Translational Science ◽

10.1017/cts.2019.446 ◽

2019 ◽

Vol 4 (5) ◽

pp. 451-456

Author(s):

Rosemary Nabaweesi ◽

Leanne Whiteside-Mansell ◽

Samantha H. Mullins ◽

Mallikarjuna R. Rettiganti ◽

Mary E. Aitken

Keyword(s):

Home Visit ◽

Parent Report ◽

Sleep Position ◽

Infant Sleep ◽

Safe Sleep ◽

Perfect Agreement ◽

Smartphone Technology ◽

Sleep Environment ◽

Sleep Safety ◽

Sleep Location

AbstractIntroduction:Sudden unexpected infant death is the leading cause of infant mortality with black: white infant mortality remaining at 2:1 for the last decade. Smartphone technology provides a convenient and accessible tool for injury prevention anticipatory guidance among at-risk communities.Materials and Methods:A convenience sample of pregnant teen mothers who own a smartphone. During a 1-month postnatal home visit, a safe sleep environment survey was administered, infant sleep practices were observed, and mothers trained to take and submit standard infants’ sleep environment photographs. Photographs were independently assessed for inter-rater reliability (IRR) across five sleep safety domains (primary outcome): sleep location, surface, position, presence of soft items, and hazards near the sleep area. Expert and novice coders IRR was measured using Cohen’s kappa coefficient (K). Sleep safety correlation between photographs and observation, and parent report and observation was determined.Results:Sixteen (57.1%) mothers completed the home visit. Most parents reported infants sleeping supine (78.5) in parents’ bedroom (85.9%). Photographs demonstrated sleep position, soft items without the baby present, and hanging toys had perfect agreement across all three coder pairs. Safe sleep experts’ IRR demonstrated perfect agreement for sleep location, position, and soft items. While 83.8% of parents were observed putting their infants down to sleep on their back, 78.5% of parents reported doing the same and 82.4% of the photographs demonstrated supine infant sleep position.Conclusion:Using photographs, coders can reliably categorize some key infant sleep safety aspects, and photograph sleep safety is comparable to parent report and direct observation.

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An evaluation of factors associated with safe infant sleep practices among perinatal home visiting participants in Florida, United States

Journal of Child Health Care ◽

10.1177/13674935211044871 ◽

2021 ◽

pp. 136749352110448

Author(s):

Barbara Dorjulus ◽

Concha Prieto ◽

Rafaella S Elger ◽

Igbagbosanmi Oredein ◽

Vidya Chandran ◽

...

Keyword(s):

Staff Training ◽

Home Visiting ◽

Infant Sleep ◽

Bivariate Statistics ◽

Safe Sleep ◽

Bed Sharing ◽

American Academy Of Pediatrics ◽

Childhood Home ◽

Safe Sleep Education ◽

Early Childhood Home Visiting

Sleep-related deaths are a leading cause of infant mortality in Florida. The American Academy of Pediatrics recommends placing infants to sleep on their back, alone, and without soft bedding. Compliance with these guidelines varies among parents. This evaluation examined the rates of safe infant sleep practices and associated factors among 1985 participants enrolled in Florida Maternal, Infant, and Early Childhood Home Visiting (FL MIECHV) programs during 2017–2019. Participant- and program-level variables were examined in relation to three sleep practices: infant position, bedding, and bed-sharing at 2–3 months to determine which factors were associated with high rates of safe sleep outcomes. Analyses included univariate descriptive statistics, bivariate statistics, and multivariable logistic regression. Most caregivers (70%) reported always placing their babies to sleep on their back, alone, and without soft bedding. Factors such as primary language, race, education, housing situation, and year the Safe Baby™ curriculum implemented were significantly associated with safe infant sleep practices. Bearing this in mind, FL MIECHV can tailor safe sleep education, messaging, and strategies to support participants at highest risk. Recent adoption of the Safe Baby™ curriculum, and associated staff training, was an important factor influencing parents’ infant sleep practices.

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