Survey of sleeping position recommendations for prematurely born infants on neonatal intensive care unit discharge

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Abstract
Prematurely born infants are at increased risk of sudden infant death syndrome, particularly if slept prone. Yet, some prematurely born infants are slept prone despite the high risk age for sudden infant death syndrome and this may reflect the advice given by neonatal unit staff. The aim of this study was to determine neonatal units' recommendations regarding sleeping positions for premature infants prior to and after discharge. A questionnaire survey was sent to all 224 neonatal units in the United Kingdom, of which 81% responded. Analysis of their responses demonstrated that 43% of units started to sleep infants supine 1 to 2 weeks prior to discharge, but oxygen-dependent infants were slept non-supine until an older age. Non-supine sleeping was recommended by 40% of units for infants with Pierre Robin syndrome or gastro-oesophageal reflux. All units advised supine sleeping at discharge, but 29% additionally recommended side sleeping and only 58% positively discouraged prone sleeping. Written information was given to parents by 70% of the units, but few provided information which was specifically about prematurely born infants. Conclusion: The worrying lack of consistency in recommending non-prone sleeping emphasises that evidence-based guidelines for the sleeping position of convalescent prematurely born infants are required.