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Infant Care Practices and Reducing Infant Mortality: Innovative Strategies and Future Perspectives

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Public Health Statistics and Risk Assessment".

Deadline for manuscript submissions: closed (31 December 2022) | Viewed by 23162

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Special Issue Editors

Prof. Jeanine Young

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Guest Editor

School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Queensland 4556, Australia
Interests: infant care practices; safe sleeping health promotion; strategies to reduce infant mortality and sudden unexpected death in infancy; Aboriginal and Torres Strait Islander health; social vulnerability and infant care; maternal, paediatrics and child health; neonatal care; stillbirth

Dr. John M.D. Thompson

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Guest Editor

School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1010, New Zealand
Interests: paediatric epidemiology; sudden unexpected death in infancy; small of gestational age infants; longitudinal studies; stillbirths

Special Issue Information

Dear Colleagues,

Public health campaigns that have promoted infant care practices, including supine sleep, not smoking, and safe sleep environments, have succeeded in dramatically reducing sudden and unexpected infant deaths since the early 1990s. Sudden unexpected death in infancy (SUDI), which includes sudden infant death syndrome (SIDS) and fatal sleeping accidents, remains a major contributor to preventable infant mortality in most developed nations. However, in many countries, declines in infant mortality have slowed and plateaued, with most tragedies occurring in families experiencing complex and multiple social vulnerabilities.

Health professionals in both acute and community settings play a pivotal role in ensuring that new parents are provided with safe sleep health promotion information, ideally in a non-judgemental manner relevant to their specific circumstances. However, a recently identified priority is that future research should involve multidisciplinary approaches to investigate innovative approaches, and to develop a deeper understanding of sustainable strategies in order to improve the safety of infant sleep for families experiencing social vulnerabilities.

We welcome papers that address infant care practices and their relationship with risk factors for infant mortality, including measures of community awareness and caregiver uptake of safe sleep recommendations, and the identification of infant care practices that are the most difficult to understand and implement. In particular, this Special Issue seeks to highlight innovative multidisciplinary approaches to reduce infant death that acknowledge a socioecological lens to capture and address the complex and multifactorial nature of disadvantage experienced by many families who suffer from a sudden and unexpected infant death.

We look forward to receiving your contribution to a Special Issue that promotes this “sociological” turn and collaborative approach, which identifies priorities for sudden infant death research.

Prof. Jeanine Young
Dr. John M.D. Thompson
Guest Editors

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

infant care practices
sudden unexpected death in infancy
sudden infant death syndrome
safe sleep campaigns
infant mortality prevention
health promotion
social and cultural determinants
priority populations
socioecological approaches to family support

Published Papers (9 papers)

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Research

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11 pages, 734 KiB

Open AccessArticle

Evaluation of Infant Injury Prevention Education Provided during Antenatal Classes after Two Years: A Pilot Prospective Cohort Study

by Chikako Honda, Kyoko Yoshioka-Maeda, Hitoshi Fujii, Riho Iwasaki-Motegi and Noriko Yamamoto-Mitani

Int. J. Environ. Res. Public Health 2022, 19(12), 7195; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19127195 - 11 Jun 2022

Cited by 1 | Viewed by 1785

Abstract

This study examined the long-term effects of an infant injury prevention program implemented during an antenatal class of 131 mothers. Questionnaires were completed 2 years postpartum to assess the incidence of injury (medically attended or home-care), mothers’ perception of injury prevention, implementation of safety practices, and active attitudes toward injury prevention. Responses were obtained from 68 (51.9%) mothers (intervention group, 40; control group, 28), including 24 who reported medically attended injuries and 55 who reported home-care injuries. The incidence of medically attended injuries did not differ between groups. The incidence of home-care injuries was also not significantly different, but was lower in the intervention group (72.5% vs. 92.9%, p = 0.050). Significantly fewer children in the intervention group experienced “injury due to being caught between objects” (12.5% vs. 39.3%, p = 0.014). Mothers in the intervention group were significantly more aware of injury prevention than those in the control group (p = 0.033). The risk of home-care injuries was inversely related to mothers’ injury-prevention perception (odds ratio [OR]: 0.55, p = 0.035). This study suggests that group education during pregnancy regarding injury prevention increases mothers’ perception of injury prevention. These findings support implementing injury prevention education during antenatal classes. Full article

(This article belongs to the Special Issue Infant Care Practices and Reducing Infant Mortality: Innovative Strategies and Future Perspectives)

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13 pages, 2842 KiB

Open AccessArticle

A Box to Put the Baby in: UK Parent Perceptions of Two Baby Box Programmes Promoted for Infant Sleep

by Helen L. Ball, Catherine E. Taylor and Cassandra M. Yuill

Int. J. Environ. Res. Public Health 2021, 18(21), 11473; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182111473 - 31 Oct 2021

Cited by 3 | Viewed by 2611

Abstract

Between 2016 and 2019, two different infant sleeping-box interventions were implemented in England: (1) shallow polypropylene baby boxes were distributed via a feasibility study to families with Sudden Infant Death Syndrome (SIDS) risk factors; and (2) a commercial–health system partnership scheme distributed cardboard baby boxes to new mothers in particular locations. We conducted parent evaluations of both interventions at the time of implementation. The views of 79 parents receiving polypropylene boxes and 77 parents receiving cardboard boxes were captured using online questionnaires and telephone interviews. Participants provided feedback on education received about using the box, their perception of the box design and materials, their experiences of using the box they received, and whether they would recommend it to others. Parents appreciated that both boxes provided a portable space to place their baby near them anywhere in the home, discouraging other riskier practices. The polypropylene box was rated more favourably regarding transparency, hygiene, and portability outside the home. A minority of parents found the idea of putting their baby in any box unappealing; however, younger mothers and smokers particularly appreciated the ability to safely co-sleep with their babies using the shallower box. Overall, the versatility of the polypropylene box scheme was more positively evaluated than the cardboard baby box scheme, which, stripped of its social value as part of a larger welfare provision, had minimal value for parents that received it. Full article

(This article belongs to the Special Issue Infant Care Practices and Reducing Infant Mortality: Innovative Strategies and Future Perspectives)

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11 pages, 751 KiB

Open AccessArticle

Assessing Social Determinants of Health in a Prenatal and Perinatal Cultural Intervention for American Indians and Alaska Natives

by Rosalina James, Martell A. Hesketh, Tia R. Benally, Selisha S. Johnson, Leah R. Tanner and Shelley V. Means

Int. J. Environ. Res. Public Health 2021, 18(21), 11079; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182111079 - 21 Oct 2021

Cited by 3 | Viewed by 2944

Abstract

American Indians and Alaska Natives (AIANs) refer to cultural traditions and values to guide resilient and strength-based practices to address maternal and infant health disparities. Methods: A case study of a culturally-based educational intervention on AIAN maternal and child health. Results: Cultural teachings have successfully been applied in AIAN behavioral interventions using talking circles and cradleboards, but maternal and child health interventions are not well-represented in peer-reviewed literature. Zero publications included interventions centered around cradleboards and safe sleep. Discussion: There is a need for rigorous published research on culturally based interventions and effectiveness on health outcomes for mothers and babies. Conclusions: This paper discusses how a cradleboard educational intervention incorporates national guidelines to address maternal and infant health while mediating social determinants of health. Full article

(This article belongs to the Special Issue Infant Care Practices and Reducing Infant Mortality: Innovative Strategies and Future Perspectives)

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13 pages, 557 KiB

Open AccessArticle

Infant Injury Prevention Education for Pregnant Women Attending Antenatal Class: A Quasi-Experimental Study

by Chikako Honda, Takashi Naruse, Hayato Yamana and Noriko Yamamoto-Mitani

Int. J. Environ. Res. Public Health 2021, 18(17), 9393; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18179393 - 06 Sep 2021

Cited by 1 | Viewed by 2226

Abstract

It is important to educate caregivers in order to prevent infant injuries. However, there have been few studies on the effects of education on pregnant women. This study aimed to evaluate the effects of injury prevention group education on this group. Study participants were recruited from a group of pregnant mothers attending an antenatal class in Tokyo. Participants were assigned to either the intervention or control group based on the month in which they attended the existing antenatal class. Both groups received a leaflet on injury prevention, but only the intervention group received an additional short one-shot lecture. The implementation of each of the nine safety practices was assessed during home visits after childbirth. Of the 131 study participants (56 in the control group and 75 in the intervention group), 106 (80.9%) received home visits after birth. Mothers in the intervention group implemented three practices significantly more than those in the control group: Keep soft objects away from the baby’s head (38.3% vs. 13.0%), Do not place your baby on a high surface (74.6% vs. 52.2%), and Use the baby carrier correctly (93.3% vs. 76.1%). In the future, we plan to follow up the participants to evaluate the program’s long-term effects, and to continue to improve the program. Full article

(This article belongs to the Special Issue Infant Care Practices and Reducing Infant Mortality: Innovative Strategies and Future Perspectives)

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11 pages, 303 KiB

Open AccessArticle

Evaluation of a Multisite Safe Infant Sleep Education and Crib Distribution Program

by Trina C. Salm Ward, Terri J. Miller and Iman Naim

Int. J. Environ. Res. Public Health 2021, 18(13), 6956; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18136956 - 29 Jun 2021

Cited by 4 | Viewed by 2381

Abstract

Rates of sleep-related infant deaths have plateaued in the past few decades despite ongoing infant sleep practice recommendations to reduce risk of sleep-related infant deaths by the American Academy of Pediatrics. The state department of public health trained facilitators at 28 sites across the state to facilitate a group safe sleep educational program. A prospective, matched pre- and post-test cohort design with follow-up was used to evaluate changes in self-reported knowledge, intentions, and practices. The final sample included 615 matched pre- and post-test surveys, and 66 matched follow-up surveys. The proportion of correct responses on all knowledge and intended practice items increased significantly from pre- to post-test. When asked where their babies would have slept if they had not received the portable crib, 66.1% of participants planned to use a recommended sleep location (e.g., crib or bassinet). At post-test, 62.3% planned to change something about their infant’s sleep based on what they learned. At follow-up, knowledge was maintained for all but two items and practices and for half of practice items. The results suggest that participating in the education program was associated with increased knowledge and intended adherence, but that these changes were not maintained at follow-up. These results are in line with the research literature that finds a difference in intentions and actual practices after the baby is born. Full article

(This article belongs to the Special Issue Infant Care Practices and Reducing Infant Mortality: Innovative Strategies and Future Perspectives)

9 pages, 294 KiB

Open AccessArticle

Infant Safe Sleep Promotion: Increasing Capacity of Child Protective Services Employees

by Carolyn R. Ahlers-Schmidt, Christy Schunn, Ashley M. Hervey, Maria Torres, Cherie Sage, Martha Henao and Stephanie Kuhlmann

Int. J. Environ. Res. Public Health 2021, 18(8), 4227; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18084227 - 16 Apr 2021

Cited by 1 | Viewed by 2155

Abstract

Sleep-related infant deaths, including Sudden Infant Death Syndrome (SIDS), are the number one cause of death in infants between 28 days and one year of life. Nearly half of families experiencing a sleep-related infant death in Kansas were involved with the Department of Children and Families Child Protective Services (CPS), making CPS staff a priority for safe sleep training. This study assessed the impact of the two-day Kansas Infant Death and SIDS (KIDS) Network Safe Sleep Instructor (SSI) train-the-trainer program on CPS staffs’ knowledge of the American Academy of Pediatrics safe sleep recommendations. Training was attended by 43 participants, 27 (63%) of whom were employed by CPS. CPS staff had significantly lower baseline knowledge on the 10-item pretest (t = 3.33, p = 0.002), but both CPS and other attendees showed significant improvement by posttest (t = 8.53, p < 0.001 and t = 4.44, p < 0.001, respectively). Following SSI certification, CPS SSIs provided more safe sleep training to professionals than other SSIs (1051 vs. 165, respectively), and both groups of SSIs were able to significantly increase the knowledge of their trainees. Overall, the KIDS Network SSI training was successful. The innovative partnership with CPS allowed for provision of training to a group not historically targeted for safe sleep education. Full article

(This article belongs to the Special Issue Infant Care Practices and Reducing Infant Mortality: Innovative Strategies and Future Perspectives)

15 pages, 768 KiB

Open AccessArticle

Feasibility and Acceptability of a Tailored Infant Safe Sleep Coaching Intervention for African American Families

by Trina C. Salm Ward, Jane McPherson and Steven M. Kogan

Int. J. Environ. Res. Public Health 2021, 18(8), 4133; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18084133 - 14 Apr 2021

Cited by 1 | Viewed by 2326

Abstract

Background: Approximately 3600 infants die suddenly and unexpectedly annually in the United States. Research suggests limitations of current behavioral interventions to reduce the risk for sleep-related deaths among African American families living in under-resourced neighborhoods. Guided by the theory of planned behavior and the socio-ecological model, the My Baby’s Sleep (MBS) intervention intends to reduce the risk for sleep-related infant deaths while addressing complex needs of African American families living in under-resourced neighborhoods. Objective: To assess feasibility and acceptability of MBS, a 7-month intervention that includes four home visits and multiple check-ins via phone and text message. Methods: This was a single-arm feasibility and acceptability study with quantitative and qualitive measures. African American families were recruited from community agencies that served an under-resourced metropolitan area. Results: Eight families (eight mothers, nine co-caregivers) completed the intervention. Families reported high acceptability of MBS content, process, and format, as evidenced by qualitative data and mean evaluation scores. Conclusion: MBS is feasible and acceptable among African American families living in under-resourced neighborhoods. These results suggest further investigation of MBS intervention efficacy in a large-scale randomized controlled trial. Full article

(This article belongs to the Special Issue Infant Care Practices and Reducing Infant Mortality: Innovative Strategies and Future Perspectives)

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Review

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26 pages, 803 KiB

Open AccessReview

Infant Care Practices, Caregiver Awareness of Safe Sleep Advice and Barriers to Implementation: A Scoping Review

by Roni Cole, Jeanine Young, Lauren Kearney and John M. D. Thompson

Int. J. Environ. Res. Public Health 2022, 19(13), 7712; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19137712 - 23 Jun 2022

Cited by 1 | Viewed by 2992

Abstract

Modifiable infant sleep and care practices are recognised as the most important factors parents and health practitioners can influence to reduce the risk of sleep-related infant mortality. Understanding caregiver awareness of, and perceptions relating to, public health messages and identifying trends in contemporary infant care practices are essential to appropriately inform and refine future infant safe sleep advice. This scoping review sought to examine the extent and nature of empirical literature concerning infant caregiver engagement with, and implementation of, safe sleep risk-reduction advice relating to Sudden Unexpected Deaths in Infancy (SUDI). Databases including PubMed, CINAHL, Scopus, Medline, EMBASE and Ovid were searched for relevant peer reviewed publications with publication dates set between January 2000–May 2021. A total of 137 articles met eligibility criteria. Review results map current infant sleeping and care practices that families adopt, primary infant caregivers’ awareness of safe infant sleep advice and the challenges that families encounter implementing safe sleep recommendations when caring for their infant. Findings demonstrate a need for ongoing monitoring of infant sleep practices and family engagement with safe sleep advice so that potential disparities and population groups at greater risk can be identified, with focused support strategies applied. Full article

(This article belongs to the Special Issue Infant Care Practices and Reducing Infant Mortality: Innovative Strategies and Future Perspectives)

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Other

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7 pages, 461 KiB

Open AccessBrief Report

Pregnant Women’s Intentions to Implement Safety Practices for Preventing Infant Injury: A Cross-Sectional Study

by Chikako Honda, Takashi Naruse and Noriko Yamamoto-Mitani

Int. J. Environ. Res. Public Health 2021, 18(1), 24; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18010024 - 22 Dec 2020

Cited by 3 | Viewed by 2474

Abstract

Injury prevention education for pregnant women may be beneficial for infants’ safety. Currently, knowledge about the scope of an expectant mother’s intent to prevent injury is limited. The objective of this study was to determine pregnant women’s intentions to implement infant injury prevention strategies. From May to June 2017, a self-administered questionnaire based on the precaution adoption process model was distributed among pregnant women who participated in a parenting preparation class in a city, Tokyo. Pregnant women’s intentions to implement the following eight kinds of safety practices were measured: three practices regarding suffocation, two regarding falls, one safety practice for burns, one for accidental ingestion, and one for traffic accidents. Among 132 respondents (response rate: 83.5%; mean age: 33.4 years; mean gestational age: 29 weeks), the most common unawareness issue was “Make sure that there is no space between the mattress and bed frame” (68.2%), followed by “Use a firm mattress or futon” (38.5%) and “Keep soft objects away from the baby’s head in the baby’s sleep area” (31.8%); 58% or more women reported having already “decided to implement” the other five practices. Safety practices that pregnant women were mostly unaware of were for preventing suffocation, despite this being a leading cause of death in terms of unintentional infant injury. In comparison, the safety practices for falls, burns, and accidental ingestion were more known to pregnant women. The pregnant women’s intention to implement injury prevention for infants varied by safety practices. These findings could be used to improve the focus of antenatal education programs for the prevention of infant injury. Full article

(This article belongs to the Special Issue Infant Care Practices and Reducing Infant Mortality: Innovative Strategies and Future Perspectives)

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