Ethnic origin and care giving styles relevant to cot death

ABSTRACT

OBJECTIVE: To examine whether ethnic origin is related to care giving styles relevant to sudden infant death. DESIGN: Prospective/Retrospective, descriptive METHOD: In six child health care centres in Amsterdam, the Netherlands, data about sleep position, bedclothes and passive smoking of infants aged 1-5 months were collected by face-to-face interviews of mothers visiting these centres between February 1997 and October 1998. RESULTS: Eligible for study were 1815 infants, 919 boys and 896 girls, mean age 2 months. In Amsterdam 12.5 percent of infants were usually or sometimes put to sleep in a prone position, 31.0 percent usually or now and then in a side position (but not in a prone position) and 56.5 percent usually in a supine position. Prone sleeping position was more frequent among Surinamese infants and less frequent among Moroccan infants compared with Dutch infants. Overall use of a duvet among infants was 22.7 percent. Use of duvets was higher among allochtonous infants; after controlling for demographic factors this difference was not significant, however. 6.3 percent of the infants had slept in the previous night with a pillow. Use of a pillow was much more frequent among allochtonous than among autochtonous infants 13 percent versus 1.2 percent. Maternal daily smoking during pregnancy and smoking by mothers or others at home at time of interview was found in 15.1 percent and 25.8 percent of the infants respectively. Almost no Moroccan mothers smoked during preganancy (0.4 percent), while Turkish mothers smoked as much as Dutch mothers (18.5 percent and 21.6 percent respectively). No differences in daily smoking at home were found between Surinamese, Moroccan and Dutch families (circa 26 percent). However, daily smoking at home was much more frequent in Turkish families (43.8 percent). CONCLUSION: Health education about a safe sleeping position, about safe bedclothes and about the dangers of passive smoking is needed. Education programmes to prevent sudden infant death must take into account ethnic differences in care giving styles. Special attention must be paid to the use of a pillow among allochtonous infants. (AU)