International Child Care Practices Study: infant sleep position and parental smoking.
The International Child Care Practices Study (ICCPS) collected descriptive data from 21 centres in 17 countries. In this report, data are presented on the key sudden infant death syndrome (SIDS) risk factors of infant sleep position and parental smoking.


METHODS
Using a standardised protocol, parents of infants were surveyed at birth by interview, and at 3 months of age mainly by postal questionnaire. Data entry and descriptive analysis were undertaken with Epi Info. Centres were grouped according to geographic location. Also indicated was the level of SIDS awareness in the community, i.e. whether any campaigns or messages to "reduce the risks of SIDS" were available at the time of the survey.


RESULTS
Birth interview data were available for 5488 individual families, and 4656 (85%) returned questionnaires at 3 months. Overall, 52.5% (95% CI, 43.5-61.3) of infants were placed in the supine or back sleep position, 37.8% (95% CI, 30.6-45.7) in the side position and 13% (95% CI, 9.3-17.9) in the prone or front position. The prevalence of supine sleeping ranged from 14% (Santiago, Chile) to 89% (Tokyo/Yokohama, Japan). The prevalence of reported smoking was between 0% and 34% for mothers and 10% and 64% for fathers. In samples from Western countries, there was a trend for rates of maternal smoking to be similar to paternal smoking, whereas in other samples, low rates of maternal smoking contrasted with high rates of paternal smoking.


CONCLUSIONS
These data highlight considerable variations and interesting patterns in the prevalence of these two important SIDS risk factors in these diverse samples. Impressive differences in rates of smoking within and between these communities may reflect different stages of the inevitable progression of the smoking epidemic, but may also provide some encouragement that reduction in smoking rates, in both mothers and fathers, is possible.
Nelson
E A
EA
Department of Paediatrics, The Chinese University of Hong Kong, 6/F Clinical Science Building, Prince of Wales Hospital, Shatin, Hong Kong, China. tony-nelson@cuhk.edu.hk
Taylor
B J
BJ
D014943:Global Health; D006801:Humans; D007224:Infant Care / Q000379:methods*; D007231:Infant, Newborn; D007391:International Cooperation; D008425:Maternal Behavior; D010332:Paternal Behavior; D012307:Risk Factors; D012890:Sleep / Q000502:physiology*; D012907:Smoking / Q000009:adverse effects*; D013398:Sudden Infant Death / Q000208:ethnology / Q000209:etiology* / Q000517:prevention & control; D016683:Supine Position / Q000502:physiology; D011795:Surveys and Questionnaires; D013689:Telephone