SIDS Prevention: When Lack of Knowledge Isn't the Problem

Many new mothers lack sufficient information or resources to appropriately care for their infants. As a result, they may inadvertently place their children at risk for negative health outcomes, including sudden infant death syndrome (SIDS). Looking to identify parenting information needs, we conducted exploratory, qualitative research across the state of Georgia with first-time mothers of low-to-moderate income. We completed 10 focus groups with 92 new mothers and 20 interviews with clinical providers who care for them.

Nearly all mothers interviewed indicated they had been informed that infants should be placed on their backs to sleep and should not co-sleep with a parent in a bed. However, few study participants followed these recommendations. African-American women and Latinas in particular saw co-sleeping as a culturally ingrained practice superseding medical recommendations. For sleep safety in particular, it is not a lack of knowledge that determines behavioral decisions of new mothers, but rather other influencing factors.

Provider responses echoed focus group findings, indicating that they counsel patients regarding “back to sleep,” but less on the issue of co-sleeping, in part because of the difficulty of changing behavior with such a strong cultural influence. Several providers also noted that low-income mothers face additional barriers to compliance with sleep recommendations.

These findings raise important questions about how to address sleep safety while maintaining a culturally appropriate perspective. These findings will inform the development of new parenting programs and materials in the state and should thus focus on bridging the gap between knowledge and behavior.