Technology may improve infant sleep safety, reduce sudden unexpected deaths
Guidelines from the American Academy of Pediatrics (AAP) caution parents on the dangers of sudden unexpected infant deaths (SUIDs). However, more than 3,000 babies in the United States die each year as a result of unsafe sleeping environments and accidental suffocations.
To help parents safeguard their children, a Penn State College of Medicine research team studied whether telehealth technologies could improve sleep safety among infants. During the study, clinicians provided AAP recommendations for safe sleep in response to images of infant sleep environments that patients submitted through the e-health portal.
The study, led by MD/MPH Program alumnus Dr. Ethan Canty, included 109 mothers and newborns who were patients at Penn State Health Milton S. Hershey Medical Center from October 2018 through June 2019. The majority of women were from dual-income households and had college educations and private health insurance. Participants were divided into intervention and control groups.
Participants used an e-health portal to upload monthly photographs of their babies sleeping. Canty and the team used a checklist to evaluate the photos for potential risk factors and provided AAP-approved recommendations to improve sleep safety.
“The study was an innovative way to explore how we can provide more personalized safe infant sleep guidance based on actual images of infants sleeping,” said Canty, a pediatrics resident at Oregon Health & Sciences University.
During the first month, less than half in the intervention group posted photos of their baby’s sleeping environment. From the photos received, researchers noted that 33% of babies were not sleeping in a room with a caregiver, 5% were sleeping on non-firm surfaces and 10% had loose bedding. Researchers did not contact mothers in the control group during this period.
During the second month, both groups uploaded photos. Among the intervention group, 56% met all the safety guidelines compared to 46% in the control group. Photos revealed infants sleeping in rooms alone (43%), cribs with loose bedding (15%) and babies sleeping with items (8%).
“Preventing sudden unexpected infant deaths is one of the most important public health challenges of today, and finding new and more personal ways to address unsafe sleep practices will be necessary if we are to reduce incidences of SUID,” Canty said.
The researchers said that while it is feasible to use e-health portals to educate parents about SUIDs and infant sleeping environments, using the platform for interventions had its share of challenges.
Overall, responses from participants were low. The researchers said this may be the result of parents adjusting to life with a newborn or not being comfortable with using technology. The majority of the intervention group (58%) never shared a monthly photo. Among the images that were submitted, many did not reflect proper implementation of AAP guidelines. The results showed that there were no significant differences between the groups in their adherence to the safety recommendations.
According to the researchers, further improvements are needed to fully communicate associated risks and promote safe sleep practices to parents of newborns. They said future studies could explore ways to not only streamline the enrollment process for study participants, but also enhance the e-health portals’ capabilities to ensure these platforms are user-friendly, accessible and mobile responsive.
“Although the current study had its challenges, I hope that it will open new avenues to solve this public health issue of our nation’s newborns,” Canty said. “The increased use of telehealth during the current pandemic makes interventions like this more feasible to implement and possibly more effective.”
Benjamin Fogel, Jessica Beiler, Ian Paul, Erich Batra and Eric Schaefer of Penn State College of Medicine also contributed to this research.
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