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FOR RELEASE: July 12 , 2007
CONTACT: Pamela Williams
Office of Communications
405/271-5601

Oklahoma Works Toward Meeting Safe Sleep Goals for Babies

How do you put your baby to sleep? Tummy-side down, on its side, or on his or her back? The preferred method is to place infants on their backs to sleep. This position has been found to reduce the risk of Sudden Infant Death Syndrome, or SIDS, for some infants.

In a study on infant sleep positions conducted by the Oklahoma State Department of Health, only 56 percent of Oklahoma newborns were placed on their backs to sleep. This falls far short of the federal Healthy People 2010 goal of 70 percent of infants placed on their backs for safe sleep.

“All babies should be placed on their backs to sleep unless there is a specific medical reason given by the doctor against it,” said Secretary for Health and State Health Commissioner Dr. Michael Crutcher. “Our hope is to reach new parents, grandparents and other caregivers with the information that putting babies to sleep on their backs can save lives.”

In the Oklahoma study, health officials utilized the Pregnancy Risk Assessment Monitoring System (PRAMS), a statewide random survey, to collect information about infant sleep positions. During the study period of 2000 – 2003, about 44 percent of Oklahoma infants 2 to 6 months old were not placed on their backs to sleep. The PRAMS study showed that 26 percent of mothers reported using the side sleep position. The side sleep position was most commonly reported among Hispanic women and mothers under the age of 20. Another 19 percent placed their infants on their stomachs; African American women were much more likely to utilize this position compared to their counterparts.

The study revealed that persons who most need targeted information on this issue include women with low incomes between 100-185 percent of federal poverty level, African American women, and women with more than one child.

Mothers most likely to use the back position were age 35 or older. American Indian women over 35 were the only group of Oklahoma mothers to reach or exceed the national goal of 70 percent for infants placed on their backs to sleep.

Common barriers to using the “back to sleep” position have been identified in other studies as a lack of correct information about how to reduce the risk of SIDS, a fear of infant choking, a lack of correct advice from family members or a provider, a lack of trust in the health care provider, and a concern for the comfort of the infant.

“Although proper sleep position alone cannot reduce infant mortality, it is one simple and easy intervention for parents and caregivers to implement,” said Crutcher.

Other factors for safe sleep that should be considered by parents or caregivers include omitting the baby’s exposure to cigarette smoke, and evaluating the condition and composition of the baby’s sleep environment, such as the type of sleep surface and the type of bedding. Health officials caution that sharing a bed with an infant is not recommended due to the potential for an unintentional injury. Instead, infants should have a separate sleep surface in the same room as their parent or caregiver.

As a result of this study, the Oklahoma State Department of Health offers the following recommendations for health care professionals:

  • Give expectant mothers, fathers and their families accurate information on sleep position and safe sleep environments during the preconception, prenatal care, delivery room and pediatric contacts and visits.
  • Provide safe sleep education during childbirth and breastfeeding classes.
  • Focus interventions on groups least likely to place their infants on their backs to sleep.
  • Target education with women who smoke or have a family member who smokes and provide them with the Oklahoma Tobacco Helpline number: 1-800-Quit-Now or 1-800-784-8669.
  • Include fathers and other caregivers in discussions about safe sleeping environments.
  • Create a state policy on infant safe sleep and revise a public education campaign to help reduce infant mortality.
  • Develop hospital policies and train postpartum, newborn nursery and neonatal intensive care unit medical and nursing staff to model and discuss safe sleep practice in the hospital.
  • Advocate for all marketing practices to show safe sleep positions.
  • Strengthen death scene investigations by using a tool developed by the federal Centers for Disease Control and Prevention to more accurately report infant deaths.

For more information on sleep position and safe sleep environments for babies, call Margaret DeVault, public health social work coordinator, Oklahoma State Department of Health’s Maternal and Child Health Services, 405-271-4480.

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