Infant activity and sleep behaviors in a maternal and infant home visiting project among rural, southern, African American women.

BACKGROUND: Physical inactivity and inadequate amounts of sleep are two potential causes for excessive weight gain in infancy. Thus, parents and caregivers of infants need to be educated about decreasing infant sedentary behavior, increasing infant unrestrained floor time, as well as age specific recommended amounts of sleep for infants. The aims of this study were to determine if maternal knowledge about infant activity and sleep changed over time and to evaluate maternal compliance rates with expert recommendations for infant sleep in a two-arm, randomized, controlled, comparative impact trial. METHODS: Pregnant women at least 18 years of age, less than 19 weeks pregnant, and residing in a lower Mississippi Delta county were recruited between March 2013 and December 2014. Postnatal data was collected from 54 participants between September 2013 and May 2016. McNemar's test of symmetry was used to determine if maternal knowledge changed over time, while generalized linear mixed models and Kaplan-Meier survival curves were used to assess compliance with expert recommendations for infant sleep. RESULTS: The postnatal retention rate was 85%. Maternal knowledge significantly increased for correct infant sleep position (back) and beginning tummy time by one month of age. Odds of meeting sleep duration recommendations increased by 30% for every one month increase in infant age. Only 20% of the participants were compliant with the back to sleep recommendation for the first 12 months of their infant's life; median time to noncompliance was 7.8 months. CONCLUSIONS: Although baseline knowledge concerning infant activity and sleep was high in this cohort of rural, Southern, African American mothers, compliance with recommendations was not optimal. TRIAL REGISTRATION: The study was registered at clinicaltrials.gov (NCT01746394) on December 5, 2012.