Factors That Influence Parents' Adherence to Safe Sleep Guidelines.

OBJECTIVE: To explore factors that influence parental behaviors related to newborn sleep positions and environments in the home after hospital discharge.

DESIGN: A descriptive qualitative study conducted by telephone.

SETTING: A 290-bed academic teaching hospital in an urban setting with a Level 3 perinatal center and approximately 4,500 births per year.

PARTICIPANTS: Participants (N = 60) were recruited from the patient population of the mother-baby unit. All participants were scheduled to be discharged simultaneously with their newborns.

METHODS: Qualitative interviews with grand tour-style questions were conducted by telephone. An inductive analysis process was used to identify themes and meaning.

RESULTS: Participants described three consistent factors that influenced how the newborn slept at home. The most frequently mentioned influence was Other People followed by Nobody/No One and Images from sources such as books, pictures, television, and the Internet.

CONCLUSION: New parents need education about the rationale for the safe sleep guidelines from the American Academy of Pediatrics (AAP) as well as knowledge of the potential harm of behaviors such as bed sharing and prone or side-lying positions for sleeping. The images to which parents are exposed send mixed messages. Health care professionals should portray safe sleep for infants in media, marketing materials, and other graphic representations. Nurses should help parents understand the AAP's recommendations for safe sleep position and environment for infants so that they can become advocates for their newborns' well-being.