Journal Club: "Back to sleep" gains have reached plateau

An analysis of data from the National Infant Sleep Position Study, an annual national telephone survey of about 1,000 caretakers of infants aged up to 7 months, shows that from 1993 to 2001, supine sleep increased for all infants. This increase reached a plateau in 2001, however, with the incidence of supine sleep position staying the same through 2007. Throughout the 15-year period, the African-American population has consistently used the supine position less often than other population groups. Currently, infants are put to sleep on their backs by about 75% of Caucasian parents and 58% of African-American parents.

Although many demographic variables were associated with use of the supine sleep position in the earlier years of the survey, these variables were no longer significant by 2003 through 2007. Instead, differences in use of supine sleep position during this recent period can be explained almost entirely by parental concern about comfort (parents without this concern were 12 times more likely to use the supine position), parental concern about choking (parents without this concern were 8 times more likely to use the supine position), and advice from a physician to put the infant on his or her back. The prevalence of such physician advice has increased from 5.8% in the earliest time period to 53.6% in recent years. Parents whose physicians advise supine sleeping are 2.6 times more likely to regularly put their babies on their backs to sleep than those who are given no advice about sleeping position (Colson ER, et al. Arch Pediatr Adolesc Med. 2009;163[12]:1122-1128).

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