An app developed by researchers at the University of Bristol assesses the risk of sudden unexpected death in infancy (SUDI)
Baby Sleep Planner app. Credit: University of Bristol
and improves the communication of safer sleep advice to families. Following positive appraisals from professionals and families, it could soon be rolled out more widely.
The rate of SUDI, or sudden infant death syndrome (SIDS), dramatically dropped with the advent of the Back to Sleep campaign in the 1990s. It now accounts for only one death in every 3000-4000 births in England. However, SIDS is still a leading cause of infant mortality, with most cases occurring in unsafe sleep environments. Importantly, unexplained infant deaths are disproportionately higher in the most deprived neighbourhoods (42% versus 8% in the least deprived).
Dr Anna Pease, a research fellow at Bristol Medical School, explained to Medscape News UK: “Most maternity and postnatal services already include varying levels of support based on need. This new risk assessment could help to identify 1 in 12 infants where the risks may be higher, meaning that more intensive support with following safer sleep advice can be delivered to those families who need it most.” Pease is lead author of the study that reported family and healthcare professional feedback on the tool in JMIR Pediatrics and Parenting.
Targeting Resources to Families Most at Risk
The Baby Sleep Planner enables professionals to assess SUDI risk at birth, and offers a downloadable sleep plan for at-risk families with advice from the Lullaby Trust. Initial user testing demonstrated that 22 health professionals, including health visitors, midwives, and family nurses, said they appreciated its functionality, which allowed them to identify and improve communications with at-risk families.
Reactions were also positive among 20 parents interviewed by the researchers, who appreciated the information as useful and appropriate. They also said the specific infant sleep plans would benefit them and other family members.
Realistic Strategies for Safer Sleeping Environments
The planner enables parents to develop realistic strategies for providing a safe sleeping environment and offers motivation through planning, goal setting, and increasing confidence. The research team noted that an approach that moves away from information giving toward information exchange is more effective with some people.
Pease explained: “Traditionally, safer sleep advice is given as a list of things to do and things to not do, often in a leaflet. For many families, this approach is fine with them and, indeed, safer sleep campaigns have greatly reduced infant deaths across the globe. However, the inequalities we now see in infant deaths tell us that we have to do better for those families where this approach has not worked.
“We have listened to families who have said that telling them what to do does not work, and they value conversations that include their views, that seek to understand their reasons for doing things, and that can help them to understand the potential risks to their babies and make a plan that works for them.”
Co-principal investigator Peter Blair, professor of epidemiology and statistics at the University of Bristol, added that the planner is “a useful tool when usual routine is disrupted, giving whoever is looking after the baby a plan.”
Future Plans
The team is now conducting a larger study to evaluate how the intervention is implemented. “We have included the baby sleep planner into a package of resources and we will test this out with health visitors, family nurse partnership nurses, and neonatal staff,” said Pease.
Blair added that the National Child Mortality Database is housed at the University of Bristol, so if the tool were rolled out more widely, they could monitor and see any reduction in baby deaths in real time.
Asked to comment by Medscape News UK, Jenny Ward, chief executive of the Lullaby Trust, said: “We welcome the development of a planning tool that aims to improve the uptake of lifesaving, safer sleep advice, particularly when normal routines are disrupted.