Gaps in Safe Sleep Knowledge and Practices Among Parents of Infants in an Urban Children's Hospital Emergency Department.

Objective: Sudden Unexpected Infant Death (SUID) remains a leading cause of mortality, particularly in the Southeast United States. While previous studies have examined aspects of parental safe sleep knowledge and practices, the objective of this study was to evaluate (1) knowledge and (2) practice of adherence by caretakers to all American Academy of Pediatrics (AAP) A-level recommendations related to placing an infant to sleep.

Methods: Investigators administered a survey study in an urban, academic pediatric emergency department in the Southeast United States from 2022 to 2023. A convenience sample of parents of infants (≤12 mo) were surveyed regarding knowledge and practices pertaining to sleep position, safe surfaces, surface sharing, objects in bed, cardiopulmonary monitors, and pacifier use. Wilcoxon signed-rank tests were used to compare knowledge of each AAP recommendation with practice of the same recommendation.

Results: Among 200 surveyed participants, most demonstrated correct knowledge of safe sleep position (183, 91.5%), surfaces (167, 83.5%), location (186, 93.0%), and crib-safe objects (177, 88.5%). Correct practices of AAP recommendations were reported for sleep position (155, 77.5%), sleep surface (155, 77.5%), location (157, 78.5%), objects in the crib (130, 65.0%), and pacifier use (73, 37.5%). For the 5 AAP recommendations, Wilcoxon signed-rank tests indicated statistically significant variance between knowledge and practice: safe sleep position (P<0.001), surfaces (P=0.040), location (P<0.001), crib-safe objects (P<0.001), and pacifier use (P=0.002).

Conclusions: This research identifies gaps between safe sleep knowledge and practice for 5 of the 6 AAP recommendations related to placing an infant to sleep in a region with high SUID incidence. Addressing these modifiable risk factors during emergency department visits may decrease SUID incidence.