TOPLINE: 

Most mothers who recently gave live birth in Illinois followed some of the recommended practices for infant sleep and care; however, only 19.3% followed all six recommendations, and adherence varied significantly by education, socioeconomic status, and other factors.

METHODOLOGY:

• Researchers conducted a cross-sectional analysis of survey data from 2016 to 2020 linked to birth certificates to assess patterns of infant sleep and care practices in Illinois.
• They analyzed responses from 5687 mothers who had recently delivered a live birth and completed a survey 2-6 months postpartum.
• The survey asked whether mothers followed six recommendations, including four sleep practices — placing the infant on the back to sleep; using an approved surface to sleep (crib, bassinet, or pack-and-play); no bed sharing; and no soft items in the sleep area (blankets, toys, bumper pads, etc) — and two care practices: breastfeeding for at least 8 weeks and no maternal smoking.
• Six clusters were formed based on the number and combination of recommendations mothers followed and were used to define practice patterns.

TAKEAWAY:

• Overall, 82.1% of mothers placed their infants on their backs to sleep, 64.1% used an approved sleep surface, 60.2% did not share beds, 49.6% kept items away from the sleep area, 67.7% breastfed for at least 8 weeks, and 90.8% did not smoke.
• Only 19.3% of mothers followed all six recommended practices; another 8.1% followed all four sleep practices but not the two care practices.
• Mothers who followed all six practices were more likely to be non-Hispanic White, aged 35 years or older, have fewer prior births, higher education, and higher socioeconomic status (all P < .0001).

IN PRACTICE:

"Public health programs and health care professionals can support equity in infant sleep safety by assessing and considering each family's situation and supporting all families to implement recommendations in the sleep and home environment to reduce SUID [sudden unexpected infant death] risk," the authors of the study wrote.

"[The study] provides robust data for perinatal health providers to develop, implement, and evaluate innovative safe infant sleep initiatives targeted to the array of practices reported by Illinois mothers to reduce SUID risk across their state," experts wrote in a commentary accompanying the journal article.

SOURCE:

This study was led by Abigail Holicky, MPH, of the College of Medicine at the University of Illinois in Chicago. It was published online on September 22, 2025, in Pediatrics.

LIMITATIONS: 

Data were self-reported by mothers, which may introduce recall bias. The survey questions focused on usual practices without considering changes across practices or changes that might occur as the infants grow older. The findings may not generalize beyond Illinois.

DISCLOSURES:

This study received funding from the Illinois Title V Maternal and Child Health Services Block Grant Program, administered by the Health Resources and Services Administration. The authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.