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MCN Am J Matern Child Nurs. 1999 Nov-Dec;24(6):301-4.

Infant sleep position. Nursing practice and knowledge.

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Alfred I. duPont Hospital for Children, Wilmington, Delaware 19899, USA.



(1) to examine the extent to which maternal/child health nurses caring for children accept the American Academy of Pediatrics recommendations on infant sleep position, (2) to determine if nurses are practicing according to the AAP recommendations, and (3) to determine the type of bedding utilized in the two institutions for infants.


Descriptive survey using 103 nurses in 2 institutions, and an observational assessment of nurses' practice.


Findings revealed that 97% of the nursing staff were aware of the AAP recommendations, although only 67% agreed with the recommendations. The observational component of the investigation evaluated the sleep position during hospitalization of 206 infants < 6 months old on both the pediatric and maternity units of the two institutions. Fifty-five percent of the infants were observed to be in the side-lying position, 29% in the recommended supine (back) position, and 16% in the prone (abdomen) sleeping position. The recommended firm bedding was observed with 63% of the infants, whereas the remainder of the infants were observed to be on foam mattresses, extra blankets, or gel packs.


Because side sleeping position was observed in the majority of infants, and one-third of the nurses queried disagreed with the AAP recommendations, education of nurses about Sudden Infant Death Syndrome prevention through "Back to Sleep" is still necessary.

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