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  • Publication # 13-RA010

Socioeconomic status does not influence how black parents position their infants for sleep

Disparities/Minority Health

Since 1992, the incidence of sudden infant death syndrome (SIDS) has decreased by 50 percent. Yet, black infants remain twice as likely as white infants to be placed on their stomachs instead of their backs—the position recommended to prevent SIDS. 

Recently, researchers surveyed black parents about their infant sleep position to see how this practice varied by socioeconomic status (SES). They found no differences in infant sleep position practices among black families based on SES. However, their findings suggested that black families with lower SES can benefit from sleep position recommendations from their health care provider. 

Image: A photograph shows a sleeping infant. Black parents with infants 6 months of age or younger were recruited from primary care pediatric clinics and private practices. The 412 parents participated in a 15-minute survey delivered by staff. They were asked about their knowledge of SIDS, their attitudes and practices about infant sleep positions, and demographic characteristics. 

Of the 412 parents, 264 were of lower SES and 148 were of higher SES. The majority of parents (62.9 percent) exclusively placed infants on their backs to sleep. Another 8.5 percent placed infants on their side, while 9.5 percent placed infants on their stomachs. Nearly 20 percent did not consistently use one sleep position. 

The researchers found no differences in the use of any infant sleep position based on SES or educational level. Those parents with higher SES were significantly more likely to say they knew what SIDS was. No significant differences were observed between higher and lower SES groups when it came to identifying the supine sleep position as the recommended position for infants. The same was true for believing that prone sleeping places babies at increased risk for SIDS.

Parents who received a recommendation that they place their infants on their back for sleeping from their health care providers were more likely to know what SIDS was and that the supine position was recommended by the American Academy of Pediatrics. This recommendation for lower SES families made them more likely to occasionally use the supine position and less likely to use the side position. The study was supported in part by AHRQ (HS16892). 

See "Factors influencing infant sleep position: Decisions do not differ by SES in African-American families," by David Robida, M.D., and Rachel Y. Moon, M.D., in the Archives of Diseases in Childhood 97, pp. 900-905, 2012.


Page last reviewed July 2013
Internet Citation: Socioeconomic status does not influence how black parents position their infants for sleep: Disparities/Minority Health. July 2013. Agency for Healthcare Research and Quality, Rockville, MD.


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