Knowledge, Attitudes, and Risk for Sudden Unexpected Infant Death in Children of Adolescent Mothers: A Qualitative Study.
To investigate practices, knowledge, attitudes, and beliefs regarding infant sleep among adolescent mothers, a demographic at high risk for sudden unexpected infant death, and to identify novel public health interventions targeting the particular reasons of this population.



Seven targeted focus groups including 43 adolescent mothers were conducted at high school daycare centers throughout Colorado. Focus groups were recorded, transcribed, validated, and then analyzed in NVivo 10. Validation included coding consistency statistics and expert review.



Most mothers knew many of the American Academy of Pediatrics recommendations for infant sleep. However, almost all teens reported bedsharing regularly and used loose blankets or soft bedding despite being informed of risks. Reasons for nonadherence to recommendations included beliefs that babies are safest and sleep more/better in bed with them, that bedsharing is a bonding opportunity, and that bedsharing is easier than using a separate sleep space. The most common justifications for blankets were infant comfort and concern that babies were cold. Participants' decision making was often influenced by their own mothers, with whom they often resided. Participants felt that their instincts trumped professional advice, even when in direct contradiction to safe sleep recommendations.



Among focus group participants, adherence with safe sleep practices was poor despite awareness of the American Academy of Pediatrics recommendations. Many mothers expressed beliefs and instincts that infants were safe in various unsafe sleep environments. Future study should investigate the efficacy of alternative educational strategies, including education of grandmothers, who have significant influence over adolescent mothers.
Pulmonary Section, Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO. Electronic address: Michelle.Caraballo@UTSouthwestern.edu.
Michelle
M
Caraballo
Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado, Aurora, CO.
Suzuho
S
Shimasaki
The Breathing Institute, Children's Hospital Colorado, Aurora, CO.
Katherine
K
Johnston
Department of Health Systems, Management and Policy, Colorado School of Public Health, University of Colorado, Aurora, CO.
Gregory
G
Tung
Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado, Aurora, CO; The Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine, Aurora, CO.
Karen
K
Albright
Pulmonary Section, Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO.
Ann C
AC
Halbower
D000293:Adolescent; D001512:Bedding and Linens; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015370:Infant Equipment; D007231:Infant, Newborn; D008423:Maternal Age; D036301:Qualitative Research; D012307:Risk Factors; D012890:Sleep; D013398:Sudden Infant Death / Q000517:prevention & control*
SIDS; SUID; accidental suffocation and strangulation in bed; adherence; bedsharing; co-sleeping; safe sleep; sudden infant death syndrome; teenage