title: Differences in Infant Care Practices and Smoking among Hispanic Mothers Living in the United States.
abstract: To assess the association between maternal birth country and adherence to the American Academy of Pediatrics safe sleep recommendations in a national sample of Hispanic mothers, given that data assessing the heterogeneity of infant care practices among Hispanics are lacking.
  
  
  
  We used a stratified, 2-stage, clustered design to obtain a nationally representative sample of mothers from 32 US intrapartum hospitals. A total of 907 completed follow-up surveys (administered 2-6 months postpartum) were received from mothers who self-identified as Hispanic/Latina, forming our sample, which we divided into 4 subpopulations by birth country (US, Mexico, Central/South America, and Caribbean). Prevalence estimates and aORs were determined for infant sleep position, location, breastfeeding, and maternal smoking.
  
  
  
  When compared with US-born mothers, we found that mothers born in the Caribbean (aOR 4.56) and Central/South America (aOR 2.68) were significantly more likely to room share without bed sharing. Caribbean-born mothers were significantly less likely to place infants to sleep supine (aOR 0.41). Mothers born in Mexico (aOR 1.67) and Central/South America (aOR 2.57) were significantly more likely to exclusively breastfeed; Caribbean-born mothers (aOR 0.13) were significantly less likely to do so. Foreign-born mothers were significantly less likely to smoke before and during pregnancy.
  
  
  
  Among US Hispanics, adherence to American Academy of Pediatrics safe sleep recommendations varies widely by maternal birth country. These data illustrate the importance of examining behavioral heterogeneity among ethnic groups and have potential relevance for developing targeted interventions for safe infant sleep.
authors.affiliation: Department of Pediatrics, Yale University School of Medicine, New Haven, CT.
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Provini
authors.affiliation: Slone Epidemiology Center, Boston University, Boston, MA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Corwin
authors.affiliation: Slone Epidemiology Center, Boston University, Boston, MA.
authors.forename: Nicole L
authors.initials: NL
authors.lastname: Geller
authors.affiliation: Department of Biostatistics, Boston University School of Public Health, Boston, MA.
authors.forename: Timothy C
authors.initials: TC
authors.lastname: Heeren
authors.affiliation: Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA.
authors.forename: Rachel Y
authors.initials: RY
authors.lastname: Moon
authors.affiliation: Data Coordinating Center, Boston University School of Public Health, Boston, MA.
authors.forename: Denis V
authors.initials: DV
authors.lastname: Rybin
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Carrie K
authors.initials: CK
authors.lastname: Shapiro-Mendoza
authors.affiliation: Department of Pediatrics, Yale University School of Medicine, New Haven, CT. Electronic address: eve.colson@yale.edu.
authors.forename: Eve R
authors.initials: ER
authors.lastname: Colson
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000639:trends; D017691:Caribbean Region / Q000208:ethnology; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007224:Infant Care / Q000379:methods* / Q000639:trends; D007231:Infant, Newborn; D008297:Male; D008425:Maternal Behavior / Q000208:ethnology; D008800:Mexico / Q000208:ethnology; D009034:Mother-Child Relations; D011247:Pregnancy; D016684:Prone Position; D012111:Residence Characteristics; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012890:Sleep / Q000502:physiology*; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D013020:South America / Q000208:ethnology; D013398:Sudden Infant Death / Q000208:ethnology / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult
keywords: Hispanic; infant mortality; sudden infant death syndrome; sudden unexpected infant death