The Dutch 11th safe sleeping survey; factors with a potential risk for suffocation

Monique Pauline L'Hoir, Annemieke Konijnendijk, Adèle Engelberts, Magda Boere Boonekamp

Research output: Contribution to conferenceAbstractAcademic

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Background: In the Netherlands, the incidence of Sudden Unexpected Death in Infancy (SUDI: R95, R96, R98, R99, W75, W78, W79) was 0,2 in 2004 and 0.15 per 1000 live births in 2016. Since 2004 the incidence of SIDS/Cot death (R95) is less than 20 infants a year. As times are changing, new potentially risky infant care behaviors develop, such as bed and sofasharing and the use of soft devices etc.

Objective: The aim of this survey is to measure the prevalence of suffocation related risk factors following the methodology put forward by Cowan’s ‘Through the tubes’: cover (soft bedding), pinch (prone sleeping), bend (car seats, wrong use of breastfeeding pillow, baby carrier) and press (bed- or sofa sharing). Furthermore, smoking remains hindering oxygen sufficiency for babies in pregnancy, which is also related to the risk of suffocation.

Methods: From February to April 2017 a random sample survey among parents of infants (0-12) was conducted. 9000 flyers were send with a request to fill in an online questionnaire (52 questions) were distributed to parents together visiting 139 well-baby clinics throughout the country. To increase the response of parents in disadvantaged neighborhoods, support of a research assistant was offered to fill out the questionnaire in 21 well-baby clinics.

Results: In total 1289 respondents filled in the online questionnaire (14,3%) in of which 1209 were complete. Comparison with national data shows that in this survey first children were overrepresented (55,5% v. 45,3%), the amount of low educated mothers was similar (14,1 % v. 13,2%), high educated mothers were overrepresented (57,2 v. 47,8) and mothers with a migration background were
underrepresented (13,5% v. 29,3%). Comparison between the survey of 2017 and 2011 shows that paternal smoking increased, maternal smoking decreased and parents who both smoke decreased. From 2011 to 2017: duvet use increased from 2,2% to 4,5% and use of a pillow from 1,5% to 2,0%. Furthermore, 2,6% used a baby bumper in the baby bed and 37,8 used stuffed animals in bed (cover). Prone sleeping increased from 2,3% in 2011 to 7,2% in 2017 (pinch), bed sharing reduced from 16,7% to 7,8%, and ‘falling asleep at the same surface’ increased from 36,3% to 46,3%, and incidentally falling asleep on sofa or chair increased from 26,4% to 49,9%. In 2017 7,8% sometimes placed the baby to sleep on a sofa or chair (press). In 2017 13,7% used a co-sleeper or click-bed. Of the parents 41,9% sometimes placed the child to sleep in the stroller, 28,0% in the car seat, 27% in a baby carrier, 6,0% on a feeding pillow and 0,4% on a bean bag (bend). Only 9,3% never placed an infant to sleep on one of these products.

Conclusion: Continuous attention should be given to safe sleeping, with special attention tot new fashions and products that may potentially increase the risk of SIDS or accidental suffocation.
Original languageEnglish
Number of pages1
Publication statusPublished - Jun 2018
Event2018 International Conference on Stillbirth, SIDS and Baby Survival - Glasgow, United Kingdom
Duration: 7 Jun 20189 Jun 2018


Conference2018 International Conference on Stillbirth, SIDS and Baby Survival
Country/TerritoryUnited Kingdom


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