Stastny PF, Ichinose TY, Thayer SD, Olson RJ, Keens TG. Infant sleep positioning by nursery staff and mothers in newborn hospital nurseries. Nurs Res. 2004; 53(2):122-129.

The American Academy of Pediatrics has clearly established that infants who are put to sleep prone are at increased risk of becoming victims of sudden infant death syndrome (SIDS). It recommends that all infants be placed supine to sleep. This study investigated whether nurses are following these guidelines in their practice and whether they are teaching parents this information as well.

Newborn nursery nurses (n = 96) in 8 hospitals in California were given questionnaires regarding their understanding of infant positioning regarding SIDS. In addition, the mothers of infants from the same nursery (n = 579) also received questionnaires on whether they had received any education about sleep positioning for their infants.

The data showed that 68.4% of the nurses had placed newborn infants on their sides and that they had taught the mothers to place the infants on either their side or back. The nurses reasoned that side-placement was better due to fear of aspiration (90.8%), even though the American Academy of Pediatrics had ruled side positioning as a risk factor for SIDS and not a risk factor for aspiration. In addition, the mothers reported that they were taught by the nurses to use the side or back positions for their infants.

These data indicate that immediate reinforcement of positioning recommendations be done with nursing staff to emphasize the safety of supine positioning and the risk that side-lying positions have for SIDS. To further reduce the incidence of SIDS cases, it is imperative that nurses follow established guidelines regarding newborn and infant positioning.