Infant sleep position and associated health outcomes.
BACKGROUND
The incidence of sudden infant death syndrome has decreased in the United States as the percentage of infants sleeping prone has decreased, but persisting concerns about the safety of supine sleeping likely contribute to prone sleeping prevalence rates that remain higher than 10%.


OBJECTIVE
To document health outcomes in infants aged 1 to 6 months in relation to sleep position.


METHODS
Prospective cohort study.


METHODS
Massachusetts and Ohio, from February 21, 1995, to December 31, 1998.


METHODS
A total of 3733 infants with consistent sleep positions at ages 1, 3, and 6 months.


METHODS
Descriptive statistics and multiple logistic regression analysis relating sleep position at each follow-up age to symptoms in the prior week (fever, cough, wheezing, stuffy nose, trouble breathing or sleeping, diarrhea, vomiting, or spitting up) and outpatient visits in the prior month (ear infection, breathing problem, vomiting, spitting up, colic, seizure, accident, or injury).


RESULTS
No symptoms or outpatient visits were significantly more common among infants sleeping on the side or supine than in infants sleeping prone, and 3 symptoms were less common: (1) fever at 1 month in infants sleeping in the supine (adjusted odds ratio [OR], 0.56; 95% confidence interval [CI], 0.34-0.93) and side positions (OR, 0.48; 95% CI, 0.28-0.82); (2) stuffy nose at 6 months in the supine (OR, 0.74; 95% CI, 0.61-0.89) and side positions (OR, 0.82; 95% CI, 0.68-0.99); and (3) trouble sleeping at 6 months in the supine (OR, 0.57; 95% CI, 0.44-0.73) and side positions (OR, 0.69; 95% CI, 0.53-0.89). Also, outpatient visits for ear infections were less common at 3 and 6 months in infants sleeping in the supine position (OR, 0.64; 95% CI, 0.46-0.88; and OR, 0.73; 95% CI, 0.58-0.92, respectively) and at 3 months in the side position (OR, 0.68; 95% CI, 0.49-0.96).


CONCLUSIONS
No identified symptom or illness was significantly increased among nonprone sleepers during the first 6 months of life. These reassuring results may contribute to increased use of the supine position for infant sleeping.
Department of Pediatrics, Medical College of Ohio, Toledo, USA. huntc@nhlbi.nih.gov
Carl E
CE
Hunt
Samuel M
SM
Lesko
Richard M
RM
Vezina
Rosha
R
McCoy
Michael J
MJ
Corwin
Frederick
F
Mandell
Marian
M
Willinger
Howard J
HJ
Hoffman
Allen A
AA
Mitchell
D000293:Adolescent; D000328:Adult; D005006:Ethnicity; D005260:Female; D006304:Health Status; D006801:Humans; D007223:Infant; D008297:Male; D008423:Maternal Age; D015995:Prevalence; D016684:Prone Position; D011446:Prospective Studies; D012890:Sleep; D013398:Sudden Infant Death / Q000453:epidemiology / Q000209:etiology*; D014028:Tobacco Smoke Pollution; D014481:United States / Q000453:epidemiology
D014028:Tobacco Smoke Pollution