Revisiting Safe Sleep Recommendations for African-American Infants: Why Current Counseling is Insufficient
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Revisiting Safe Sleep Recommendations for African-American Infants: Why Current Counseling is Insufficient Laura M. Gaydos • Sarah C. Blake • Julie A. Gazmararian • Whitney Woodruff • Winifred W. Thompson • Safiya George Dalmida
Springer Science+Business Media New York 2014
Abstract The American Academy of Pediatrics recommends that children be placed in the supine position on firm bedding and not bed share with parents or other children. Health professionals increasingly understand that many African-American parents do not follow these recommendations, but little research exists on provider reactions to this non-compliance. This study was intended to better understand how low-income, African-American mothers understand and act upon safe sleep recommendations for newborns and how providers counsel these mothers. We conducted focus groups with 60 African-American, lowincome, first-time mothers and telephone interviews with
L. M. Gaydos (&) S. C. Blake Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, USA e-mail: [email protected] S. C. Blake e-mail: [email protected] J. A. Gazmararian Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA e-mail: [email protected] W. Woodruff Emory University Hospital, Atlanta, GA, USA e-mail: [email protected] W. W. Thompson Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA e-mail: [email protected] S. G. Dalmida School of Nursing, Emory University, Atlanta, GA, USA e-mail: [email protected]
20 providers serving these populations to explore provider counseling and patient decision making. The large majority of mothers reported understanding, but not following, the safe-sleeping recommendations. Key reasons for noncompliance included perceived safety, convenience, quality of infant sleep and conflicting information from family members. Mothers often take measures intended to mitigate risk associated with noncompliance, instead increasing SIDS risk. Providers recognize that many mothers are noncompliant and attribute non-compliance largely to cultural and familial influence. However, few provider attempts are made to mitigate SIDS risks from non-compliant behaviors. We suggest that counseling strategies should be adapted to: (1) provide greater detailed rationale for SIDS prevention recommendations; and (2) incorporate or acknowledge familial and cultural preferences. Ignoring the reasons for sleep decisions by African-American parents may perpetuate ongoing racial/ethnic disparities in SIDS. Keywords SIDS Sleep safety African-American Co-sleeping
Introduction Although Sudden Infant Death Syndrome (SIDS) rates have declined by more than 50 % in all populations in the United States since the early 1990s, there remain racial disparities [1, 2]. African-American infants are at particularly high relative risk for SIDS and (100.7 per 100,000), approximately twice that of Caucasian infants (
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