Are pediatricians up to date on safe sleep practices?

January 1, 2008

A cross-sectional survey of pediatricians and family physicians showed that most of these practitioners know that prone sleeping reduces the risk of sudden infant death syndrome (SIDS), but are not as likely to be aware of other safe sleep recommendations. However, the survey was conducted just before the 2005 American Academy of Pediatrics (AAP) policy statement about SIDS risk reduction was released.

Pediatricians accounted for almost two-thirds of the 783 completed surveys, and family physicians for one third. Overall, 78% of respondents correctly identified supine as the recommended sleep position; 18% selected supine or side, 2% other, and 2% didn't know. Almost all respondents recommended firm mattresses for infant sleeping. Most pediatricians and family physicians advised a crib or bassinet for sleep. As for room location, the practitioners were most likely to recommend a separate room (42% of each physician group), followed by "no preference" (about 38%) and sleeping in the parents' room (about 20%). The 2005 AAP recommendations released after the survey called for sharing rooms but not beds.

Recommendations for use of pacifiers in infants below 1 year of age were similar across specialties, with 11% recommending that pacifiers never be used, 26% recommending limited use, and 63% recommending unlimited use or having no preference. The 2005 AAP guidelines suggest that pacifiers may be offered at sleep time to potentially reduce the risk of SIDS, and that pacifier introduction be delayed until breastfeeding is established.

Commentary:
If this survey were repeated today, after the updated AAP recommendations for SIDS prevention were released, the participating physicians might be more knowledgeable about the best ways to prevent SIDS. Because physician counseling on SIDS prevention has been shown to change behaviors and save infants' lives, we all need to know current AAP recommendations for SIDS prevention (Pediatrics 2005;116:1245) and to continue to incorporate these guidelines in anticipatory guidance.