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Parents' choice of non-supine sleep position for newborns: a cross-sectional study

02 September 2014
9 min read
Volume 22 · Issue 9


The objective of this study was to investigate the sleeping position of infants attending an outpatient clinic, considering the influences of the back to sleep (BTS) campaign. A paper survey was given to 678 parents who presented their infant (under 1 year of age) to the paediatric chiropractic clinic for care asking their infant's sleep position.

Of the total survey sample, 50‥ of parents selected the supine position as the preferred position they placed the baby to sleep, 19‥ of parents preferred to place their babies prone, 34‥ on the babies side and 2‥ selected other. Some mothers selected more than one preferred sleeping position.

The initial decline of mothers using non-supine positioning, seen shortly after the implementation of the BTS campaign, is no longer evident. Recent research implies approximately half of infants are now placed in a non-compliant sleeping position. If an infant’s most preferred sleeping position is not that of current guidelines, manual therapy such as chiropractic care should be sought to help infants sleep supine with comfort.

The back to sleep (BTS) campaign was introduced to encourage the supine positioning of infants when sleeping (American Academy of Pediatrics (AAP) 1992; NHS Choices, 2012) to reduce the risk of sudden infant death syndrome (SIDS). Before this, more than 70% of infants in the US were being placed prone to sleep (Davis et al, 1998). In the UK before 1990, at least 58% of babies were placed to sleep prone (Fleming et al, 1990). This was likely due to the stated recommendations from health care books between 1943 and 1988 (Gilbert et al 2005). The relationship between the prone sleeping position and SIDS was first suggested in 1965 (Chung-Park, 2012). Due to this presumption and further research, a supine sleeping position has been recommended worldwide since 1992 to all parents with infants in good health and born at full-term.

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