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Factors influencing infant sleep position: decisions do not differ by SES in African-American families
  1. David Robida1,
  2. Rachel Y Moon2,3
  1. 1Pediatric Residency Program, Children's National Medical Center, Washington, DC, USA
  2. 2Goldberg Center for Community Pediatric Health, Children's National Medical Center, Washington, DC, USA
  3. 3Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
  1. Correspondence to Dr Rachel Y Moon, Goldberg Center for Community Pediatric Health, Children's National Medical Center, 111 Michigan Avenue, NW, Washington, DC 20010, USA; rmoon{at}


Objective To investigate factors influencing African-American parents’ knowledge, attitudes and practice regarding infant sleep position and determine if these differ by socioeconomic status (SES).

Methods A cross-sectional sample of 412 parents with infants ≤6 months of age participated in a validated survey of knowledge, attitudes and practice.

Results There was no significant difference in attitudes or practice, and knowledge was similar regarding infant sleep position between African-American parents of higher and lower SES. The healthcare provider recommendation of exclusive supine sleep position use was associated with increased knowledge, overall decreased use of the side position (5.0% vs 16.8%, p<0.01) and increased occasional use of the supine position in the lower SES group (81.6% vs 68.6%, p=0.03). It was not associated with increased positive parental attitudes about the supine sleep position in either group. Neither a senior caregiver living in the home nor observation of hospital personnel placing infants in a non-supine position was associated with differences in sleep position practices in either group.

Conclusions Sleep position practices in African-American families do not differ by SES. Improved attitudes toward positioning and increased use of supine positioning may result if healthcare providers address common concerns and misconceptions about sleep position.

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