Physician Beliefs and Practices Regarding SIDS and SIDS Risk Reduction

• Published in: Clinical pediatrics 2002-07, Vol.41 (6), p.391-395
• Main Authors: Moon, Rachel Y., Gingras, Jeannine L., Erwin, Rebecca
• Format: Article
• Language: English
• Subjects: Attitude of Health Personnel; Babies; Biological and medical sciences; Child, Preschool; Cross-Sectional Studies; District of Columbia - epidemiology; Female; Health aspects; Health Care Surveys; Health Education; Health Knowledge, Attitudes, Practice; Humans; Incidence; Infant; Infant, Newborn; Infants; Male; Medical sciences; North Carolina - epidemiology; Pediatrics; Physicians; Practice Patterns, Physicians; Prevention; Prevention and actions; Primary Prevention - methods; Probability; Prognosis; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Factors; Risk Management - methods; SIDS; Sleep; Sleep positions; Specific populations (family, woman, child, elderly...); Sudden Infant Death - epidemiology; Sudden Infant Death - prevention & control; Sudden infant death syndrome; Supine Position; Surveys and Questionnaires
• ISSN: 0009-9228; 1938-2707
• DOI: 10.1177/000992280204100603

The AAP has alerted pediatricians to the importance of safe sleep environment for infants. The elements of a safe sleep environment include supine sleep position, safe crib, and avoidance of smoke exposure, soft bedding, and overheating. With the Back to Sleep campaign, prone sleeping among all U.S. infants has decreased to less than 20%, and the incidence of SIDS has decreased 40%. However, the decline in SIDS and prone sleeping has leveled off in recent years. Further declines may be possible with decreasing other modifiable risk factors, such as prenatal and postnatal exposure to cigarette smoking. Prior studies have demonstrated that health care professional advice is influential in determining infant care practices. It is important that physicians caring for infants be aware of the importance of a safe sleep environment and understand other modifiable risk factors for SIDS. We surveyed a random sample of 3,717 physicians in North Carolina and the metropolitan Washington, DC, area to determine knowledge, beliefs, and practices regarding SIDS and SIDS risk reduction among physicians caring for pregnant women and infants. Twenty-three percent (835) responded. Most physicians are aware of prone sleeping and cigarette smoke exposure as risk factors for SIDS. Almost all physicians agree that there are measures that can be taken to reduce the risk of SIDS, and they consider it important to discuss SIDS and SIDS risk reduction strategies with parents of young infants. In spite of this belief, only 56% of family/general practitioners, 18% of obstetrician-gynecologists, and 79% of pediatricians discuss SIDS routinely. Only 35% of pediatricians, 15% of family/general practitioners, and 16% of obstetrician-gynecologists provide written information. In addition, only 38% of physicians recommend supine, while 50% recommend side or back, 6% side, and 7% prone. Only two thirds of pediatricians and one third of family/general practitioners are aware that the AAP recommends supine as the preferred sleep position for infants. Pediatricians are more likely to be aware of the AAP recommendation (p