Evaluation of Baby Sleep Position Practices and Sleep Environment

Öz

Objective: The aim of this current study was to determine mothers’ infant sleep position practices and their awareness of a safe sleeping environment.

Material and Methods: This descriptive survey was conducted with 418 mothers who had infants aged 0-6 months and who agreed to participate in pediatric outpatient polyclinics of two hospitals. Data were collected between January-December 2020 via-structured questionnaires by face-to-face interview.

Results: Of the 418 mothers; 28% placed their babies in the supine sleeping position, 59.6% used a pillow when they put their babies in bed and 76.8% used a soft mattress. 42.3% of mothers covered their babies’ faces during sleep; primary school graduate mothers were more intended on covering their babies’ faces than high school and university graduates (p<0.001). 4.1% of mothers smoked during pregnancy, 9.8% during the lactation period and 15.3% were exposed to household smoke. All of the mothers shared a room with their babies without sharing a bed. There was also a positive correlation between the number of prenatal visits of mothers and their preference to put their babies to sleep in the supine position (p=0.010).

Conclusion: Most of the mothers placed their babies in a side sleeping position. Mothers’ avoiding sharing beds and smoking cigarettes and prone positioning their children at a very low frequency were pleasing measures. Mothers who had more prenatal visits were found to place their babies more in the supine sleep position. Increasing the awareness of healthcare providers and other secondary caregivers about a safe sleeping environment and baby sleep position during pre and postnatal visits would make right practices become widespread.

Anahtar Kelimeler

• Mothers
• Sudden Infant Death Syndrome
• Infant
• Sleep

Bebek Uyku Pozisyonu Uygulamalarinin ve Uyku Ortaminin Değerlendirilmesi

Öz

Amaç: Bu çalışmanın amacı, annelerin bebek uyku pozisyonu uygulamalarını ve güvenli uyku ortamı farkındalıklarını belirlemektir.

Gereç ve Yöntemler: Tanımlayıcı tipte olan bu araştırma, iki hastanenin çocuk polikliniklerine çalışmaya katılmayı kabul eden 0-6 aylık bebeği olan 418 anne ile yapıldı. Veriler, Ocak-Aralık 2020 tarihleri arasında yapılandırılmış anket yoluyla yüz yüze görüşme yoluyla toplanmıştır.

Bulgular: 418 annenin %28’i bebeklerini sırtüstü pozisyonda yatırırken, %59.6’sı yastık ve %76.8’i yumuşak yatak kullanmış, %42.3’ü uykuda iken bebeklerinin yüzünü örtmüşlerdir. İlkokul mezunu anneler, lise ve üniversite mezunlarına göre daha fazla bebeklerinin yüzünü örtmeye eğilimli idiler (p<0.001). Annelerin %4.1’i gebelikte, %9.8’i emzirme döneminde sigara içmişler ve %15.3’ü ev içi sigara dumanına maruz kalmıştı. Annelerin tamamı yatak paylaşımı olmaksızın bebekleriyle aynı odayı paylaşıyordu. Annelerin doğum öncesi ziyaret sayısı ile bebeklerini sırt üstü yatırma tercihleri arasında pozitif yönde ilişki bulundu (p=0.010).

Sonuç: Annelerin çoğu bebeklerini yan yatış pozisyonuna yerleştirmişlerdir. Annelerin yatak paylaşımından, sigara içmekten kaçınmaları ve çocuklarını çok düşük sıklıkta yüzüstü pozisyonda uyutmaları sevindirici önlemlerdi. Doğum öncesi ziyaretleri daha fazla olan annelerin bebeklerini daha çok sırt üstü yatış pozisyonuna yerleştirdiği saptandı. Doğum öncesi ve sonrası ziyaretlerde sağlık hizmeti sunucuları ve diğer ikincil bakıcıların güvenli uyku ortamı ve bebek uyku pozisyonu konusunda bilinçlendirilmesi doğru uygulamaların yaygınlaşmasını sağlayacaktır.

Anahtar Kelimeler

• Anneler
• Ani Bebek Ölümü Sendromu
• Bebek
• Uyku

Kaynakça

1. Komakech H, Lubogo D, Nabiwemba E, Orach GC. Essential newborn care practices and determinants amongst mothers of infants aged 0-6 months in refugee settlements, Adjumani district, west Nile, Uganda. PLoS One 2020; 15: e0231970.
2. Willinger M, James LS, Catz C. Defining the sudden infant death syndrome (SIDS): deliberations of an expert panel convened by the National Institute of Child Health and Human Development. Pediatr Pathol 1991;11: 677-84.
3. Hirai AH, Kortsmit K, Kaplan L, Reiney E, Warner L, Parks SE, et al. Prevalence and Factors Associated With Safe Infant Sleep Practices. Pediatrics 2019;144:e20191286.
4. Cole R, Young J, Kearney L, Thompson J. Infant Care Practices, Caregiver Awareness of Safe Sleep Advice and Barriers to Implementation: A Scoping Review. Int J Environ Res Public Health 2022; 23;19:7712.
5. Centers for Disease Control and Prevention User Guide to the 2016 Period Linked Birth/Infant Death Public Use File. Accessed: 14 January 2021. Available from: http://www.cdc.gov/
6. Moon RY, Carlin RF, Hand I. Evidence Base for 2022 Updated Recommendations for a Safe Infant Sleeping Environment to Reduce the Risk of Sleep-Related Infant Deaths. Pediatrics 2022;150:e2022057991.
7. Turkey Demographic and Health Survey. Hacettepe University Institute of Population Studies. Accessed: 13 January, 2021. Available from: https://hips.hacettepe.edu.tr/en/demographic and_health_survey_series-353
8. Erdoğan Ç, Turan T. Risky Behaviors of Mothers with Infants on Sudden Infant Death Syndrome in Turkey. J Pediatr Nurs 2018;38:e2-e6.

9. Cesar JA, Marmitt LP, Carpena MX, Pereira FG, Neto JDM, Neumann NA, et al. Maternal Knowledge and Unsafe Baby Sleep Position: A Cross-Sectional Survey in Southern Brazil. Matern Child Health J 2019;23:183-90.
10. Yikilkan H, Ünalan Cubes P, Cakir E, Ersu Hamutcu R, Cifcili S, et al. Sudden infant death syndrome: How much mothers and health professionals know. Pediatr Int 2011; 53:24-8.
11. Özbörü Aşkan Ö, Keskindemirci G, Kılıç A, Gökçay G. Evaluation of sleep safety in infants: Preliminary results of the pilot study. Çocuk Dergisi 2018;18:135-9.
12. Newberry JA. Creating a safe sleep environment for the infant: what the pediatric nurse needs to know. J Pediatr Nurs 2019;44:119-22.
13. Kuzlu Ayyıldız T, Özdemir S, Topan A, Cebeci E, Kuzlu N, Toplu M. Estimation of Awareness of Acts and Information on Sleep Safety in Those Parents that Have 0-13-month-old Babies. Journal of Turkish Sleep Medicine 2020;2:73-9.
14. Erdoğan Ç, Turan T. Mothers’ preferences for safe sleep in newborns. J Turk Sleep Med 2018;5:58-61.
15. Goodstein MH, Stewart DL, Keels RE, Moon RY. Transition to a Safe Home Sleep Environment for the NICU Patient. Pediatrics 2021;148:e2021052046.
16. Ballardini E, Sisti M, Basaglia N, Benedetto M, Baldan A, Borgna-Pignatti C, et al. Prevalence and characteristics of positional plagiocephaly in healthy full-term infants at 8-12 weeks of life. Eur J Pediatr 2018;177:1547-54.
17. Meral C, Öztürk B, Purisa S, Çelik Y. Çocuk Polikliniğinde İzlenen Bebeklerin Uyuma Pozisyonlarının Değerlendirilmesi. Çocuk Dergisi 2010;10:179-82.
18. Colson ER, Geller NL, T Heeren T, Michael J, Corwin MJ. Factors Associated with Choice of Infant Sleep Position. Pediatrics 2017; 140:e20170596.
19. Deborah Stiffler D, Sherry Mukasa Matemachani MS, Crane L. Considerations in Safe to Sleep® Messaging: Learning from African American Mothers. J Spec Pediatr Nurs 2020;25:e12277.
20. Brien NO, McGarvey C, Hamilton K and Hayes B. Maternal intentions towards infant sleeping practices in Ireland. Acta Paediatrica 2021;110:184-93.
21. Zeren E, Polat S, Taplak ŞA. Creating a safe sleep environment for babies: what are the practices performed by mothers? J Health Res 2020;36:323-33.
22. Kucuk RE, Tanriverdi G. Traditional Baby Care Practices of Mothers and their Practices Reasons: A Sample From Turkey. Int J Caring Sci 2021;14:1749-62.
23. Efe E, Sarvan S, Kukulu K. Sleep practices and environment and the risk of sudden infant death syndrome in Turkey. J Spec Pediatr Nurs 2007;12:253–63.
24. Yıldız I. Implementation of Safe Sleep Practices by Mothers with 0-1 Year-Old Infants Euras. J Fam Med 2021;10:56-64.
25. Turkish Statistical Institute. Statistics on Child 2021. Accessed: 18 July 2022. Available from: https://www.tuik.gov.tr/media/announcements/istatistiklerle_cocuk_2021.pdf
26. Anderson TM, Lavista Ferres JM, You Ren S, Moon RY, Goldstein RD, Ramirez JM, et al. Maternal Smoking Before and During Pregnancy and the Risk of Sudden Unexpected Infant Death. Pediatrics 2019; 143:e20183325.
27. Özçoban AF, Dilcen YH, Kaynak S, Uzel N. The Effect of Smoking During Pregnancy on Prenatal Attachment. OTJHS 2020;5:444-54.
28. WHO. WHO recommendations on antenatal care for a positive pregnancy experience. Accessed: 3 March 2021. Available from: www.who.int/reproductivehealth/publications/maternal_perinatal_health/anc-positive-
29. Republic of Turkey Ministry of Health. General Directorate of Public Health, Department of Women’s and Reproductive Health Antenatal Care Management Guide 2018 Ankara. Accessed: 7 April 2021. Available from: https://khgmsaglikhizmetleridb.saglik.gov.tr/Eklenti/28085/0/dogumoncesibakimyonetimrehberipdf.pdf
30. Aitken ME, Rose A, Mullins SH, Nick T, Rettiganti M, Nabaweesi R, et al. Grandmothers’ Beliefs and Practices in Infant Safe Sleep. Matern Child Health J 2016;20:1464-71.
31. Yıldız İ. What Do the Midwives and Nurses Know About Safe Sleep? J Turk Sleep Med 2021;1:43-8.
32. Angal J, Gogoi M, Zenel J, Elliott A. Physicians’ Knowledge and Practice of Safe Sleep Recommendations for Infants in South Dakota. S D Med 2019;72:349-53.
33. Newberry JA. Creating a Safe Sleep Environment for the Infant: What the Pediatric Nurse Needs to Know. J Pediatr Nurs 2019;44:119-22.