Study 1(1010 Gershon NB, Moon RY. Infant Sleep Position in Licensed Child Care Centers. Pediatrics [Internet]. 1997 [cited 2014 Jul 15];100(1):75-8. Available from: http://www.sids.org.ar/ar4.htm
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• Only 57% (75) of the nurseries were aware of the recommendations for child sleep position;
• Prevalence of infants placed in prone position at sleep time: always, 20%; sometimes, 29%; never, 51%;
• 75% of the nurseries did not have written guidelines regarding sleep position;
• Main reasons to place the child in ventral decubitus position at sleep time: child comfort, fear of asphyxia, request of child's parents;
• Only 51% of the study nurseries fully observed the AAP's recommendations regarding sleep positions;
• The nurseries that exclusively used the prone position had a mean number of children significantly lower when compared to those that used this position only sometimes or never. |
Study 2(1111 Moon RY, Biliter WM. Infant sleep position policies in licensed child care centers after back to sleep campaign. Pediatrics [Internet]. 2000 [cited 2014 Jul 15];106(3):576-80. Available from: http://pediatrics.aappublications.org/content/106/3/576
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• 75% of the nurseries were aware of the recommendations for child sleep position;
• The infants were placed in the prone position in 27.9% of the institutions, 2.9% of them were placed exclusively in this position;
• The most common reasons to avoid the prone position were: reduced infant sudden death risk and existence of licensing;
• 50% of nurseries had written guidelines regarding sleep position;
• Twenty nurseries were aware of the risks of prone position at sleep time remained placing the children for a while in this position, especially due to a request of parents;
• Only 56.9% of nurseries had heard of the BTS campaign, despite mass dissemination;
• The campaign results led to changes in the guidelines of 14 nurseries. |
Study 3(1212 Herskovic LP, et al. Encuesta telefónica sobre posición al dormir en lactantes menores de un año que asisten a una muestra de salas cuna privadas en Santiago de Chile. Rev Chil Pediatr [Internet]. 2001 [cited 2014 Jul 15];72(6):528-30. Available from: http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0370-41062001000600007&lng=es&nrm=iso&tlng=es
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• 69% (63) reported having guidelines regarding infant sleep position, but only 22% were written guidelines;
• 62% (39) set non-prone position and 38% (24) admitted or recommended the prone position;
• In 63% (57) of the nurseries, there were children who slept in the prone position, and in 19% (17), all children slept in the same position. |
Study 4(1313 Dayie RA, Aronson SS, Jansen-McWilliams L, Kelleher KJ. Use of a statewide system to improve health and safety in child care facilities. Ambul Pediatr [Internet]. 2001 [cited 2014 Jul 15];1(2):73-8. Available from: http://www.sciencedirect.com/science/article/pii/S1530156705600214
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• 88% of 400 nurseries and 71% of 400 family homes of child care had heard of ECELS and, of these, 83% of nurseries and 86% family homes of child care had used some ECELS service in the last 12 months;
• 365 of the units answered to questions about the usual child sleep position;
• Prevalence of infants in supine position at sleep time: 45%; lateral decubitus: 9%; prone: 5%; 40% reported combined positions;
• Among the ECELS users and non-users, no significant different was observed in habitual child sleep position;
• The ECELS users who did not adopt the supine position for children were more prone (p=0.02) to have written guidelines for the proper sleep position when compared to the ECELS non-users who used the same position;
• 46% of the ECELS users had guidelines for sleep position versus 28% of non-users (p=0.02);
• None of the units that had written guidelines for child sleep position reported the habit of placing children in the prone position at sleep time;
• Child care providers were satisfied with the ECELS model. |
Study 5(1414 Melchior LE, Biasoli-Alves ZMM. Comportamento de bebês na rotina diária da creche. Rev Bras Cresc Desenv Hum [Internet]. 2002 [cited 2014 Jul 15];12(2):42-51. Available from: http://www.revistas.usp.br/jhgd/article/viewFile/39693/42552
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• During 4 to 6 months of age, changes were observed in the child sex and place to sleep: for male children, baby carriage/cradle predominated as the place to start sleeping; and for female children, the cradle/enclosure;
• 100% of children aged 9 to 22 months, of both sexes, sleep in enclosures, and aged 23 and 24 months, on small mattress;
• The sleep is calm (98%) and of normal duration;
• When the children wake up, most show a behavior to entertainment (play). |
Study 6(1515 Moon RY, Weese-Mayer DE, Silvestri JM. Nighttime child care: inadequate sudden infant death syndrome risk factor knowledge, practice, and policies. Pediatrics [Internet]. 2003 [cited 2014 Jul 15];111(4):795-9. Available from: http://pediatrics.aappublications.org/content/111/4/795.long
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• In 20% of the nurseries, the children slept in the prone position, but in one nursery, the children were placed exclusively in the prone position;
• The children slept in cradles in 53.6% of the nurseries, but the sleep environment was organized and net in only 18.2% of the nurseries;
• Smoking was prohibited in 86.4% of the nurseries;
• The most frequent reason to avoid the prone position was the reduced risk of infant sudden death syndrome;
• 10 nurseries still placed the children in the prone position, at least sometimes, due to a request of the child's parents or for the child comfort;
• 59% of the nurseries had written guidelines for sleep position; however, such fact was not associated with the change from the prone position during child sleep;
• In more than one third of the nurseries that had written guidelines for sleep position, the caregivers were not aware of the content of such guidelines. |
Study 7(1616 Moon RY, Oden RP. Back to sleep: can we influence child care providers? Pediatrics [Internet]. 2003 [cited 2014 Jul 15];112(4):878-82. Available from: http://pediatrics.aappublications.org/content/112/4/878.long
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• After an intervention, the adoption of exclusive supine position by the caregivers increased from 44.8% to 78.1%;
• Six months after the intervention, 85% of the institutions kept the change to the supine position;
• The recognition of the recommended supine position as an option to infants increased from 47.9% to 78.1%, and 67.7% of the nurseries kept recognizing the supine position as the recommended sleep position, six months after the intervention;
• The existence of written guidelines for sleep position increased from 18.8% to 44.4%. |
Study 8(1717 Moon RY, Calabrese T, Aird L. Reducing the risk of sudden infant death syndrome in child care and changing provider practices: lessons learned from a demonstration project. Pediatrics [Internet]. 2008 [cited 2014 Jul 15];122(4):788-98. Available from: http://pediatrics.aappublications.org/content/122/4/788
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• The recommendation of the supine position increased from 59.7% (both groups) to 64.8% (control) and 80.5% (intervention);
• The exclusive use of the supine position increased from 65.0% to 70.4% (control) and 87.8% (intervention);
• The observed supine position increased from 51% to 57.1% (control) and 62.1% (intervention);
• After the treatment, a statistically significant reduction was observed in the use of objects next to the child, such as pillows and baby rattles, in the control group; and pillows, baby rattles, toys and blankets in the intervention group;
• The presence of written guidelines for sleep position increased from 32.1% to 54.4% in control sites and 54.9% in intervention sites; however, this change was not statistically significant. |
Study 9(1818 Hall WA, Scher A, Zaidman-Zait A, Espezel H, Warnock F. A community-based study of sleep and behaviour problems in 12- to 36-month-old Children. Child Care Health Develop[Internet]. 2011 [cited 2014 Jul 15];38(3):379-89. Available from: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2214.2011.01252.x/epdf
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• Sleep problems were reported by the parents while answering the questionnaire (indicated by score ≥12 in the ISQ for 38% of the children);
• A significant association was observed between sleep problems (changed score in the ISQ) in children of maternal age in a report of somatic complaints of children, withdrawn and internalized behavior;
• The active contact of parents with the children at bedtime was associated with difficulty sleeping alone and other problems related to night awakening, according to the ISQ scores. |
