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Fitzgerald Health Education Associates, Inc., December 2014 fhea.com
by the American Academy of Pediatrics (AAP), ac-
cording to a large, cross-sectional survey published
in Pediatrics. The AAP has identified bedding such as
pillows, blankets, and quilts as potentially hazardous
for the infant sleep environment and regard it as a
risk factor for sudden infant death syndrome and un-
intentional sleep-related suffocation.
Carrie K. Shapiro-Mendoza, PhD, MPH, and col-
leagues analyzed data from the period 1993 to 2010
from the National Infant Sleep Position study to de-
termine US prevalence of and trends in bedding use.
During the study period, reported bedding use over
or under infants for infant sleep substantially de-
clined, but about half of US infants are still placed to
sleep with potentially hazardous bedding.
Use of bedding was highest for the infants of
teenaged mothers (83.5%) and lowest for infants
born at term (55.6%). Bedding use was also fre-
quently reported among infants sleeping in adult
beds, on their sides, and on a shared surface. Young
maternal age, nonwhite race and ethnicity, and not
being college educated were the strongest predic-
tors (adjusted odds ratio, ≥1.5) of bedding use.
The rate of decline in bedding use was markedly
less from 2001 to 2010 compared with 1993 to 2000.
The investigators were unable to explain the differ-
ence in rates of decline, but they note that there was
a greater decline in bedding used over infants com-
pared with bedding used under them. They hypoth-
esize that parents may incorrectly perceive the AAP
bedding recommendation as only pertaining to
items covering or around the infant and not includ-
ing items under the infant.
The study concludes that the trends found in the
survey should be used to help tailor safe sleep inter-
ventions.
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