Safe Sleep Behaviors Among South Dakota Mothers and the Role of the Healthcare Provider.

Introduction: The purpose of this report was to determine the prevalence of safe sleep practices among South Dakota mothers, and the impact that education from their healthcare provider had on infant safe sleep practices as defined by the American Academy of Pediatrics (AAP).

Method: A population-based survey was administered to a random sample of mothers delivering in 2017. Data were weighted to obtain statewide and race-specific (white, non-Hispanic; American Indian; other races) prevalence rates.

Results: Weighted response rate was 67 percent, with 9.9 percent of mothers giving birth in 2017 completing a survey. Greater than 85 percent of mothers met recommendations regarding placing their infant on their back, breastfeeding, not consuming alcohol or illicit drugs during pregnancy, and attending 80 percent or more of prenatal visits. Less than 85 percent met recommendations regarding infant always sleeping alone on an approved sleep surface (30.8 percent), room-sharing without bed-sharing (44.3 percent), keeping soft objects and loose bed- ding out of crib (47.7 percent), and avoiding smoke exposure during and after pregnancy (82.1 percent). Only 7.7 percent of mothers met all eight recommendations. Healthcare providers talking to the mother about placing the infant to sleep in a crib and placing the crib in the mother's room were associated with a higher percent of mothers meeting these recommendations. Although the health care provider asking the mother if she was going to breastfeed was not associated with ever breastfeeding (p=0.95), if the mother received information from the doctor about breastfeeding she was slightly more likely to breastfeed than if she did not receive information (90.3 vs. 85 percent, p=0.06).

Conclusions: A low percentage of South Dakota mothers met all eight AAP safe sleep recommendations that could be assessed using these data. Health care providers can influence a mother's compliance with some of the safe sleeping recommendations.