Disparities/Minority Health

Black mothers skeptical of relationship between infant sleep position and SIDS

Despite the 50 percent decline in the incidence of sudden infant death syndrome (SIDS) in the United States since the American Academy of Pediatrics first recommended that infants sleep on their backs in 1992, black infants remain twice as likely to die from SIDS as white infants. They are also about twice as likely to sleep on their stomachs as other racial or ethnic groups. Since very little is known about how parents' beliefs and attitudes affect their decisions to adhere to safe sleep recommendations, the researchers decided to investigate perceptions about SIDS among black parents.

Rachel Y. Moon, M.D., and colleagues at Children's National Medical Center in Washington, D.C., conducted 13 focus groups with 73 black mothers of infants, as well as 10 individual interviews. They concluded that the mothers perceived the link between risk factors such as sleep position and SIDS to be implausible; SIDS to be a random, unpreventable occurrence; and parental vigilance to be the key to SIDS prevention. Many parents did not see the usefulness of changing sleep position to reduce SIDS risk unless they could be assured that this change would provide a 100 percent guarantee that SIDS would not occur. SIDS is defined as the death of an infant for which no cause is found. Most SIDS deaths occur while the infant is sleeping. However, since the cause(s) of SIDS are unknown, many mothers did not understand how the sleep position of the infant could influence the occurrence of SIDS.

If safe sleep recommendations are to be embraced by more black parents, a plausible link between the recommendations and SIDS or other sudden sleep-related deaths needs to be more clearly established for parents. That way, parents believe that their actions can be effective in reducing the risk of these deaths, suggest the researchers. Their study was supported, in part, by the Agency for Healthcare Research and Quality (HS16892).

See "Qualitative analysis of beliefs and perceptions about sudden infant death syndrome in African-American mothers: Implications for safe sleep recommendations," by Dr. Moon, Rosalind P. Oden, Brandi L. Joyner, B.S., and Taiwo I. Ajao, M.P.H., in the July 2010 Journal of Pediatrics 157, pp. 92-97.

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