你也可以既母乳喂养又保证宝宝安全睡眠：对中西部家访项目中婴儿安全睡眠数据的初步分析

You can have your breastmilk and safe sleep too: a preliminary analysis of infant safe sleep data in a Midwestern home visiting program.

作者信息

Hussain Sheena, Lowell Gina S, Roehler Douglas R, Quinlan Kyran P, Tandon S Darius, Schwartz Lesley

机构信息

Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.

Department of Pediatrics, Rush University Children's Hospital, Chicago, IL, USA.

出版信息

Inj Epidemiol. 2018 Apr 10;5(Suppl 1):14. doi: 10.1186/s40621-018-0138-y.

DOI:10.1186/s40621-018-0138-y

PMID:29637422

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5893505/

Abstract

BACKGROUND

Sudden unexpected infant death (SUID) accounted for approximately 3700 infant deaths in the US in 2015. SUID risk factors include prone sleeping, bed-sharing, soft bedding use, and maternal smoking. Infant safe sleep data in at-risk communities are difficult to obtain and home visiting programs can add to what we know. This study's purpose is to determine how often caregivers enrolled in home visiting programs provide safe sleep environments for their infants in relation to breastfeeding status and tobacco use.

METHODS

Female caregivers in at-risk communities were prospectively enrolled in Midwestern home visiting programs. Those that had infants < 365 days old and completed a safe sleep survey between October 1, 2016 and May 18, 2017 were included. Caregivers' responses (always, sometimes, or never) to three safe sleep questions were compared by breastfeeding status, caregiver tobacco use, and household tobacco use using Pearson's chi-squared or Fisher's exact test.

RESULTS

The characteristics of the 289 eligible female caregivers included 120 (42%) ≤ 21 years old, 137 (47%) black, 77 (27%) breastfeeding, and 60 (22%) with household tobacco use. Two hundred forty-six (85%) caregivers always placed infants in the supine position, 148 (51%) never bed-shared, and 186 (64%) never used soft bedding. Ongoing breastfeeding caregivers never bed-shared more often than those who never breastfed or weaned (66% vs. 53% vs. 39%, p = 0.003). Households with tobacco use placed infants in the supine position less (75% vs. 88%, p = 0.03), bed-shared more (62% vs. 44%, p = 0.04), and used soft bedding more (50% vs. 32%, p = 0.004) relative to those without tobacco use.

CONCLUSIONS

In this group of at-risk young mothers, those who breastfed bed-shared less than mothers who were not breastfeeding; this finding has implications toward reducing the SUID risk in similar populations. This study also demonstrated that infants living with a tobacco user are less likely to be sleeping safely. This suggests that a multifaceted approach to safe sleep counseling may be needed.

摘要

背景

2015年，美国约有3700例婴儿猝死（SUID）。SUID的风险因素包括俯卧睡眠、同床共眠、使用柔软床品以及母亲吸烟。高危社区的婴儿安全睡眠数据难以获取，而家访项目可以增加我们对此的了解。本研究的目的是确定参加家访项目的照顾者为婴儿提供安全睡眠环境的频率与母乳喂养状况和烟草使用之间的关系。

方法

前瞻性招募中西部家访项目中高危社区的女性照顾者。纳入那些婴儿年龄小于365天且在2016年10月1日至2017年5月18日期间完成安全睡眠调查的照顾者。使用Pearson卡方检验或Fisher精确检验，根据母乳喂养状况、照顾者烟草使用情况和家庭烟草使用情况，比较照顾者对三个安全睡眠问题的回答（总是、有时或从不）。

结果

289名符合条件的女性照顾者的特征包括120名（42%）年龄≤21岁，137名（47%）为黑人，77名（27%）进行母乳喂养，60名（22%）家庭中有烟草使用者。246名（85%）照顾者总是让婴儿仰卧，148名（51%）从不与婴儿同床共眠，186名（64%）从不使用柔软床品。正在进行母乳喂养的照顾者从不与婴儿同床共眠的比例高于从未母乳喂养或已断奶的照顾者（66%对53%对39%，p = 0.003）。与无烟草使用的家庭相比，有烟草使用的家庭让婴儿仰卧的比例更低（75%对88%，p = 0.03），同床共眠的比例更高（62%对44%，p = 0.04），使用柔软床品的比例更高（50%对32%，p = 0.004）。