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Mothers’ knowledge and attitudes to sudden infant death syndrome risk reduction messages: results from a UK survey
  1. Anna S Pease,
  2. Peter S Blair,
  3. Jenny Ingram,
  4. Peter J Fleming
  1. Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
  1. Correspondence to Anna S Pease, Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK; a.pease{at}


Objective To investigate mothers’ knowledge of reducing the risks for sudden infant death syndrome (SIDS) and attitudes towards safer sleep practices.

Design and setting A cross-sectional survey was carried out in deprived areas of Bristol, UK. Recruitment took place in 2014 at local health visitor-led baby clinics.

Participants Of 432 mothers approached, 400 (93%) completed the face-to-face survey. Participants with infants at ‘higher’ risk of SIDS (using an algorithm based on a previous observational study) were compared with those at ‘lower’ risk.

Main outcome measures The survey asked participants to recall three SIDS risk reduction strategies (unprompted), and scored responses to 14 SIDS risk-related infant sleep scenarios (prompted).

Results Overall, 48/400 (12%) mothers were classified as higher risk. Mothers in the higher risk group were less likely to breast feed (multivariate OR=3.59(95% CI 1.46 to 8.86)), less likely to be able to cite two or more unprompted correct SIDS risk reduction strategies (multivariate OR=2.05(95% CI 1.02 to 4.13)) and scored lower on prompted safer sleep scenarios overall.

Notably, only 206/400 (52%) of all mothers surveyed (33% in the higher risk group) from these deprived areas in Bristol identified infant sleep position as a risk reduction strategy for SIDS, despite 25 years of campaigns.

Conclusions Mothers in the higher risk group were disadvantaged when it came to some aspects of knowledge of SIDS risk reduction and attitudes to safer sleep. The initial ‘Back-to Sleep’ message that dramatically reduced these deaths a generation ago needs more effective promotion for today’s generation of mothers.

  • SIDS
  • epidemiology
  • sleep
  • public health
  • infant

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  • Contributors PJF, PSB and ASP conceptualised the research questions. JI, PSB and ASP designed the methods and applied for ethics. ASP carried out the study. ASP and PSB analysed the results. JI and PJF provided expert guidance on the analysis plan and the interpretation of the results. ASP wrote the paper with input from PJF, PSB and JI.

  • Funding This work was supported by The Lullaby Trust grant number 267.

  • Competing interests None declared.

  • Patient consent Consent was implied from participating in the survey.

  • Ethics approval West Midlands NHS Research Ethics Committee (ref: 13/WM/0403).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The full anonymised data set from the study may be available to other researchers. The corresponding author may be contacted to discuss any requests.