International Child Care Practices Study: infant sleeping environment.

BACKGROUND: The International Child Care Practices Study (ICCPS) has collected descriptive data from 21 centres in 17 countries. In this report, data are presented on the infant sleeping environment with the main focus being sudden infant death syndrome (SIDS) risk factors (bedsharing and infant using a pillow) and protective factors (infant sharing a room with adult) that are not yet well established in the literature. METHODS: Using a standardised protocol, parents of infants were surveyed at birth by interview and at 3 months of age mainly by postal questionnaire. Centres were grouped according to geographic location. Also indicated was the level of SIDS awareness in the community, i.e. whether any campaigns or messages to "reduce the risks of SIDS" were available at the time of the survey. RESULTS: Birth interview data were available for 5488 individual families and 4656 (85%) returned questionnaires at 3 months. Rates of bedsharing varied considerably (2-88%) and it appeared to be more common in the samples with a lower awareness of SIDS, but not necessarily a high SIDS rate. Countries with higher rates of bedsharing appeared to have a greater proportion of infants bedsharing for a longer duration (>5 h). Rates of room sharing varied (58-100%) with some of the lowest rates noted in centres with a higher awareness of SIDS. Rates of pillow use ranged from 4% to 95%. CONCLUSIONS: It is likely that methods of bedsharing differ cross-culturally, and although further details were sought on different bedsharing practices, it was not possible to build up a composite picture of "typical" bedsharing practices in these different communities. These data highlight interesting patterns in child care in these diverse populations. Although these results should not be used to imply that any particular child care practice either increases or decreases the risk of SIDS, these findings should help to inject caution into the process of developing SIDS prevention campaigns for non-Western cultures.

The significance of ante- and perinatal periods for formation of risk of sudden infant death syndrome.

The results of the research, which are carried out according to two international programs on studying and prevention of the sudden infant death syndrome (SIDS), are submitted in the article. The features of ante- and perinatal periods, characteristics of obstetric history of the mothers of deceased babies are analyzed, the relative risk of SIDS development is estimated at the influence of a complex of factors. High parity, young age of mother at the time of delivery, poor antenatal care, preterm delivery, intrauterine fetal growth retardation, fast delivery, alcohol and coffee abuse by a mother, smoking during pregnancy, early change of the child's feeding from breast to bottle are referred to the most significant risk factors of SIDS stipulated by the unfavorable course of pregnancy and delivery. The practical recommendations directed on elimination of the risk factors of SIDS in ante- and perinatal periods are offered.