title: Wahakura Versus Bassinet for Safe Infant Sleep: A Randomized Trial.
abstract: OBJECTIVE
  To compare an indigenous sleep device (wahakura) for infants at high risk for sudden unexpected death with a bassinet, for measures of infant sleep position, head covering, breastfeeding, bed-sharing, and maternal sleep and fatigue.
  
  
  METHODS
  A total of 200 mainly Māori pregnant women were recruited from deprived areas of New Zealand. They were randomized to receive a bassinet or wahakura and asked to sleep the infant in this device from birth. Questionnaires at 1, 3, and 6 months and an overnight infrared video in the home at 1 month were completed.
  
  
  RESULTS
  An intention-to-treat and an "as-used" analysis of questionnaires showed no group differences at 1, 3, and 6 months in infant-adult direct bed-sharing (7% vs 12%, P = .24 at 1 month), and at the 6-month interview, the wahakura group reported twice the level of full breastfeeding (22.5% vs 10.7%, P = .04). Maternal sleep and fatigue were not significantly different between groups. Video identified no increase in head covering, prone/side sleep position, or bed-sharing in the wahakura group, either from intention-to-treat analysis, or when analyzed for actual sleep location.
  
  
  CONCLUSIONS
  There were no significant differences in infant risk behaviors in wahakura compared with bassinets and there were other advantages, including an increase in sustained breastfeeding. This suggests wahakura are relatively safe and can be promoted as an alternative to infant-adult bed-sharing. Policies that encourage utilization are likely to be helpful in high-risk populations.
authors.affiliation: School of Midwifery, Otago Polytechnic, Dunedin, New Zealand; sally.baddock@op.ac.nz.|Departments of Women's and Children's Health, and.
authors.forename: Sally A
authors.initials: SA
authors.lastname: Baddock
authors.affiliation: Departments of Women's and Children's Health, and.
authors.forename: David
authors.initials: D
authors.lastname: Tipene-Leach
authors.affiliation: Preventive and Social Medicine, and.
authors.forename: Sheila M
authors.initials: SM
authors.lastname: Williams
authors.affiliation: Departments of Women's and Children's Health, and.
authors.forename: Angeline
authors.initials: A
authors.lastname: Tangiora
authors.affiliation: Departments of Women's and Children's Health, and.
authors.forename: Raymond
authors.initials: R
authors.lastname: Jones
authors.affiliation: Preventive and Social Medicine, and.
authors.forename: Ella
authors.initials: E
authors.lastname: Iosua
authors.affiliation: Departments of Women's and Children's Health, and.
authors.forename: Emily C
authors.initials: EC
authors.lastname: Macleod
authors.affiliation: Departments of Women's and Children's Health, and.|Dean's Department, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: Barry J
authors.initials: BJ
authors.lastname: Taylor
mesh_terms: D000328:Adult; D001513:Beds; D001942:Breast Feeding / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007223:Infant; D015370:Infant Equipment; D007231:Infant, Newborn; D008297:Male; D009520:New Zealand; D011204:Poverty Areas; D012890:Sleep; D013398:Sudden Infant Death / Q000517:prevention & control*; D014741:Video Recording