Safe co-sleeping for all babies: Do infant safer sleep boxes provide a safe and beneficial sleep environment for infants?

Abstract

This study evaluates the efficacy of providing an ‘infant safer sleep box’ (ISSB) compared to a standalone cot in the same room to reduce the occurrence of modifiable risk factors associated with SIDS whilst bed-sharing, by providing observational data of mother-infant dyads using ISSBs in the parent-infant sleep lab.

The present study recruited 11 mother-infant dyads who attended the parent-infant sleep lab for two overnight observations. A randomised crossover study design was used to compare the influence of allocating an infant safer sleep box (ISSB) and a standalone cot in the same room on night-time behaviour. Infant safer sleep boxes, modelled on New Zealand’s pēpi-pod are aiming to engage parents with safe sleep advice and provide a safe sleep space for infants. Participants were either allocated a standalone cot on the first night and an ISSB on the second night or vice versa. The study aimed to (1) collect observational data relating to the use of infant safer sleep boxes, (2) compare the effects of allocating an ISSB or a standalone cot on night-time caregiving and (3) to understand if ISSBs can provide a safe sleep environment for infants.

The study population consisted of 10 exclusively breastfeeding infants and one formula feeding infant. The average age of infants was 15 weeks with a range of 4-19 weeks and 80% of participants reported bed-sharing at least once a week. None of the sample reported currently smoking or smoking in pregnancy. On nights allocated an ISSB the study population showed a significantly greater number of looking and touching events (p=.024) and increased maternal proximity (p=.008) in comparison to nights when their infants were settled in a standalone cot in the same room. Results also indicated that allocating an ISSB may be influential in increasing the frequency and duration of breastfeeding, reduce the occurrence of head covering events and create a safer sleep environment compared to a standalone cot in the same room for a preponderance of the study population.

This study contributes to the growing understanding of portable sleep enablers as safe sleep spaces for infants who are contraindicated to bed-sharing. This study has indicated that using an ISSB did not interfere with normal infant care and may enhance parental monitoring and awareness of infants.