Maternal knowledge of recommendations for safe infant sleep and intentions for implementation – a cross sectional analysis of data from the KUNO-Kids birth cohort study

Sara Fill Malfertheiner; Janina Postpischil; Vincent D. Gaertner; Susanne Brandstetter; Alan J. Metcalfe; Birgit Seelbach-Göbel; Christian Apfelbacher; Michael Melter; Michael Kabesch; Sebastian Kerzel

doi:10.1515/jpm-2022-0349

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Article

Maternal knowledge of recommendations for safe infant sleep and intentions for implementation – a cross sectional analysis of data from the KUNO-Kids birth cohort study

Sara Fill Malfertheiner , Janina Postpischil , Vincent D. Gaertner , Susanne Brandstetter , Alan J. Metcalfe , Birgit Seelbach-Göbel , Christian Apfelbacher , Michael Melter , Michael Kabesch and Sebastian Kerzel

Published/Copyright: September 29, 2022

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From the journal Journal of Perinatal Medicine Volume 51 Issue 3

Abstract

Objectives

Despite major advances in prevention, sudden infant death syndrome (SIDS) remains an important cause of infant mortality. The aim of our study was to determine actual knowledge and intentions to implement SIDS prevention measures among new mothers and to identify potential knowledge gaps for improved postpartum counselling strategies.

Methods

Data was collected in a standardized interview from participants of the KUNO-Kids birth cohort study before discharge from maternity ward. The mothers did not receive any specific teaching prior to the interview.

Results

The majority of 2,526 interviewed mothers were able to actively report important recommendations for safe infant sleep, including the exclusive face-up position. However, 154 mothers (9%) intended to position the newborn face-down sometimes or often. The most frequently envisaged sleeping furniture was a bedside sleeper (n=1,144, 47%), but 2.2% of mothers indicated that the intended default sleeping place for the newborn would be the parents’ bed (which is discouraged by the recommendations). For 43% of the infants (n=1,079), mothers planned to have loose objects in the bed and 189 mothers (7%) intended to use a loose blanket. 22% of infants (n=554) will live in a household with a smoker. Multivariate regression showed a significant association of “good knowledge” with maternal age and with not being a single parent, whereas the household size was negatively associated.

Conclusion

Although the majority of mothers in our birth cohort were aware of many recommendations for safe infant sleep, our data also uncovered weaknesses in SIDS prevention knowledge and point to specific areas with potential for improved counselling.

Keywords: birth cohort; prevention; safe infant sleep; SIDS

Corresponding author: Sebastian Kerzel, MD, Department of Pediatric Pneumology and Allergy, University Children’s Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John, University of Regensburg, Steinmetzstr. 1-3, D-93049 Regensburg, Germany, Phone: +49 941 369 95817, Fax: +49 941 369 5424, E-mail: sebastian.kerzel@ukr.de

Acknowledgments

We would like to thank all families who participate in the KUNO-Kids birth cohort study as well as all medical students, nurses, midwives, physicians, and researchers who facilitated the recruitment of participants and data assessment. Further, we thank all members of the KUNO-Kids study group: Petra Arndt (ZNL Transfercenter of Neuroscience and Learning, University of Ulm, Ulm, Germany), Mark Berneburg (Department of Dermatology, University Medical Centre Regensburg, Regensburg, Germany), Stephan Böse-O’Reilly (Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany), Romuald Brunner (Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Bezirksklinikum Regensburg (medbo), Regensburg, Germany), Wolfgang Buchalla (Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, University of Regensburg, Regensburg, Germany), André Franke (Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Germany), Sebastian Häusler (Clinic of Obstetrics and Gynecology St. Hedwig, University of Regensburg, Regensburg, Germany), Iris Heid (Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany), Caroline Herr (Bavarian Health and Food Safety Authority (LGL), Munich, Germany), Wolfgang Högler (Department of Pediatrics and Adolescent Medicine, Johannes Kepler University Linz, Linz, Austria), Sebastian Kerzel (Department of Pediatric Pneumology and Allergy, University Children’s Hospital Regensburg, St. Hedwig Campus, Regensburg, Germany), Angela Koeninger (Clinic of Obstetrics and Gynecology St. Hedwig, University of Regensburg, Regensburg, Germany),Michael Koller (Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany), Michael Leitzmann (Department of Epidemiology and Preventive Medicine, University of Regensburg, Germany), David Rothfuβ (City of Regensburg, Coordinating Center for Early Interventions, Regensburg, Germany), Wolfgang Rösch (Department of Pediatric Urology, University Medical Center, Regensburg, Germany), Bianca Schaub (Pediatric Allergology, Dept of Pediatrics, Dr. von Hauner Children’s Hospital, University Hospital, LMU Munich, Germany), Bernhard H.F. Weber (Institute of Human Genetics, University of Regensburg, Regensburg, Germany), Stephan Weidinger (Department of Dermatology, Venereology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Germany) and Sven Wellmann (Children’s Hospital St. Hedwig, University of Regensburg, Germany.

Research funding: The KUNO-Kids health study was funded by research grants of the EU (HEALS: 603946). Further financial support was provided by the University Children’s Hospital Regensburg (KUNO-Clinics) and the clinic St Hedwig (Hospital Barmherzige Brüder Regensburg). The funding bodies played no role in the design of the study and collection, analysis and interpretation of data and in writing the manuscript.
Author contributions: SFM wrote the first draft of the manuscript. JP was responsible for the recruitment of study participants, data collection, and validation. VDG and SB performed the statistical analyses. BSG, CA, MM, and MK contributed to the design of the study, the interpretation of the results, and the authoring of the manuscript. SK developed the study question, supervised the data analysis, wrote the final manuscript, and designed the tables and figures. All authors revised the manuscript critically for important intellectual content, have accepted responsibility for the entire content of this manuscript and approved the final version of the submission.
Competing interests: Authors state no conflict of interest.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: The study was complied with all relevant national regulations, institutional policies and is in accordance with the tenets of the Helsinki Declaration (as revised in 2013) and was approved by the Ethics Committee of the University Regensburg (file number: 14-101-0347).

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Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/jpm-2022-0349).

Received: 2022-06-02

Accepted: 2022-07-16

Published Online: 2022-09-29

Published in Print: 2023-03-28

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Articles in the same Issue

https://doi.org/10.1515/jpm-2022-0349

Keywords for this article

birth cohort; prevention; safe infant sleep; SIDS