Exploring the decision making of parents around safe sleep practices

The sudden unexplained death of an infant is the most devastating tragedy that can happen to an infant, and family. Exploring the decision making of parents around their ability to follow safe sleep advice could save lives.

A baby sleeping on their back in a crib

The introduction of the Back to Sleep (later Safe to Sleep) campaign in 1994 saw a major fall in the rates of sudden unexplained death in infants (SUDI).

However, some areas still have above national average rates of SUDI, and when this has been the case, all but one baby was sleeping in the recommended safe sleep position. The aim of this research is to interview parents and explore the barriers to safe sleep practices.

SUDI is the most devastating tragedy that could happen to an infant and family. Despite substantial reductions since the 1990s, following the Back to Sleep campaign for the prevention of sudden infant death syndrome (SIDS), at least 300 babies die in England and Wales each year (Child Safeguarding Review Panel, 2020).

Local data analysed between 2017 and mid-2020 showed that, in all but one in 17 cases of infant death, the infant had been sleeping in their cot as per safe sleep advice.

The link between SUDI and sleeping arrangements is noted (Shiells et al., 2023; The Child Safeguarding Practice Review Panel, 2020; The Lullaby Trust, 2023) with numerous associated contributory factors: unplanned co-sleeping with an adult, e.g. sleeping with an infant on a sofa (The Lullaby Trust, 2023); maternal smoking during pregnancy; parental smoking and/or substance misuse; young mothers aged under 20 years; low birth weight babies; and prematurity and multiple births (The Lullaby Trust, 2022).

The literature highlights that parents are receptive to safe sleep advice, but what is also seen is that parents do not always follow safe sleep advice (Cole et al, 2022). Lack of awareness, parents tolerating or creating varying degrees of risk in their infant sleep environments, and limits in capacity to implement advice are some of the reasons noted (Volpe and Ball, 2013). A need to understand the barriers to safe sleep advice was highlighted.

This research will improve professional practices by understanding the views of parents and the barriers to safe sleep practices. It will enable practitioners to support families more effectively and further reduce the risk and associated trauma of experiencing a SUDI.