As many parents trust the advice of nurses, they are in a unique position to educate parents and caregivers about the importance of safe sleep in preventing SIDS, suffocation and accidents during sleep. Nurses have opportunities to educate parents during prenatal visits, in the hospital when the baby is born and after the baby goes home.
As infants in NICUs have an increased risk of SIDS the role of nurses is especially critical. Premature infants are more likely to be placed prone to sleep after hospital discharge. Parents frequently see NICU infants placed prone to sleep and parents may become used to the prone sleep position.
Research shows that while most nurses are aware of the AAP’s recommendation that infants be placed on their backs to sleep, they may not actually follow these recommendations. A 1999 study showed that while 97 percent of the maternal/child health nurses surveyed reported awareness of the AAP recommendations, only 67 percent agreed with them. The majority of the nurses who disagreed cited “experience” or “the potential adverse consequences of the supine position” as their reasons for disregarding the recommendations.
Studies have also found that newborn nursery staff do not uniformly recommend the supine position to families. A California study conducted at eight perinatal hospitals found that only 34 percent of the nursery staff reported consistently encouraging mothers to practice supine infant sleep positioning. Another study found that nurses with fewer years of experience are more likely to encourage parents to use the back-only position while nurses with more years experience do not use or recommend this position primarily because they believe infants do not sleep well.
Physicians, neonatal intensive care nurses and other medical professionals remain uncomfortable recommending non-prone sleeping for very low birth weight infants despite the AAP’s recommendations and the physiologic data that support it. Nurses in both well-baby units and NICUs report skepticism of the BTS message because of the fear of aspiration by the infant. In addition, nurses do not always realize that they impact parents’ sleep position decision. Modeling suggested behaviors, such as back sleeping, can be a powerful educational tool in conjunction with written educational materials.
Over the past three years, we have conducted nursing trainings at the national, regional and state-wide levels, with the following results: