The sleeping environment of young infants less than 6 months old is very important as an improper sleeping practice can lead to suffocation and sudden infant death syndrome (SIDS). Despite efforts to improve public awareness on safe practices, such as the Back to Sleep campaign, there are still a significant number of infant deaths attributed to SIDS in the US.
We’ve covered the growing number of infant wearables that claim to monitor sleeping infants, though they generally don’t explicitly claim to prevent SIDS. And we should note that there’s no data supporting most of these devices; on the contrary, home monitoring to prevent SIDS has historically not panned out in studies. In this study, a group of researchers passed on wearables and other similar technology. Instead, they focused on using mobile technology to help educate new mothers on safe sleep practices when they needed that information the most.
Moon et al. attempted to investigate whether mobile interventions can help reinforce key infant care messages. Over 1,000 mothers with newborns were recruited across 16 hospitals in the US. They were randomized to receive safe sleeping advice from either (1) a nursing quality improvement program, which follows a train-the-trainer model, (2) an mHealth intervention where mothers received daily text messages and videos for the first 11 days then every 3–4 days for 60 days, or (3) both. Breastfeeding programs of similar formats were provided as the control intervention. The key safety considerations for preventing SIDS, and therefore the key outcome measures for the study, include placing the infant in a supine position, sharing a room with the infant but not on the same bed, not using soft bedding, and to postpone using a pacifier for infants who are directly breastfed.
The only significant difference observed was the greater adherence to supine sleeping position among those in the group that received safe sleeping text messages (adjusted risk difference 8.9%). Participating in the nursing quality improvement program in addition to receiving the safe sleeping text messages seemed to provide additional improvements in positioning the infant in a supine position for sleep, but no improvement was seen in the group that received only the nursing quality improvement program. No significant differences between groups were observed for the other three outcome measures: room sharing without bed sharing (adjusted risk difference 12.4%), no soft bedding use (adjusted risk difference 11.8%), and any pacifier use (adjusted risk difference 8.7%).
This RCT demonstrates some potential of text message reminders on improving adherence to proper infant sleeping practices, while the intended goal of decreasing the incidence of SIDS remains to be empirically proven. Future studies should also explore the effectiveness of different types of mobile interventions (perhaps more interactive interventions) on adherence to proper infant sleeping practices and eventually assess its effect on SIDS incidence to draw a more convincing correlation.
