J Pediatr

Objective

To assess the association between maternal birth country and adherence to the American Academy of Pediatrics (AAP) safe sleep recommendations in a national sample of Hispanic mothers, given that data assessing the heterogeneity of infant care practices among Hispanics are lacking.

Study design

We used a stratified, 2-stage, clustered design to obtain a nationally representative sample of mothers from 32 U.S. intrapartum hospitals. 907 completed follow-up surveys (administered 2–6 months postpartum) were received from mothers who self-identified as Hispanic/Latina, forming our sample, which we divided into 4 subpopulations by birth country (U.S., Mexico, Central/South America, and Caribbean). Prevalence estimates and aORs were determined for infant sleep position, location, breastfeeding, and maternal smoking.

Results

When compared with U.S.-born mothers, we found that: mothers born in the Caribbean (aOR 4.56) and Central/South America (aOR 2.68) were significantly more likely to room share without bed sharing. Caribbean-born mothers were significantly less likely to place infants to sleep supine (aOR 0.41). Mothers born in Mexico (aOR 1.67) and Central/South America (aOR 2.57) were significantly more likely to exclusively breastfeed; Caribbean-born mothers (aOR 0.13) were significantly less likely to do so. Foreign-born mothers were significantly less likely to smoke before and during pregnancy.

Conclusions

Among U.S. Hispanics, adherence to AAP safe sleep recommendations varies widely by maternal birth country. These data illustrate the importance of examining behavioral heterogeneity among ethnic groups and have potential relevance for developing targeted interventions for safe infant sleep.

27979582

PMC5328962

Journal Article

CDC Public Access