Taking a “Conversations Approach” to Promote Breastfeeding and Safe Sleep

Posted in GUMC Stories

New parents seeking information about how to help their infants eat and sleep safely often receive lists of tips that can be confusing and even contradictory. The National Action Partnership to Promote Safe Sleep (NAPPSS), a coalition supported by the U.S. Department of Health and Human Services (HHS), aims to help new parents by taking a conversations approach–an opportunity for two-way discussion–that supports best practices for both breastfeeding and safe sleep.

“Feeding and sleeping are the two biggest concerns that new parents, who are often sleep deprived, have when they bring their infants home,” said Suzanne Bronheim, PhD, associate professor of pediatrics at Georgetown University Medical Center and leader of NAPPSS. “But because safe sleeping and breastfeeding are both integrally vital to infant survival and long-term health of mothers and infants, we need to recognize the realities that families face and their need for information to make decisions and to mitigate risks.”

Sleep-related sudden unexpected infant death (SUID) is the leading cause of post-neonatal mortality in the United States. Approximately 3,500 infants in the United States die from sleep-related deaths every year, including sudden infant death syndrome (SIDS), accidental suffocation and strangulation.

It is unclear what causes sleep-related SUID but researchers have identified several protective behaviors that appear to reduce the risk, including breastfeeding.

However, efforts to promote and support safe sleep and breastfeeding have evolved separately.

“The separation of these efforts has led to confusion for families and disagreements about what messages families should receive to keep their infants safe and healthy,” Bronheim said. “It is vital for all concerned with public health to embrace a perspective that promotes both rather than presenting the issues as ‘either/or.’”

In their updated safe sleep guidelines released October 24, the American Academy of Pediatrics (AAP) recommends that infants sleep close to their parents’ beds on separate sleeping surfaces specifically designed for infants, but “acknowledges that parents frequently fall asleep while feeding the infant.”

“If you are feeding your baby and think that there’s even the slightest possibility that you may fall asleep, feed your baby on your bed, rather than a sofa or cushioned chair,” said Lori Feldman-Winter, MD, FAAP, co-author of the new AAP report and member of the task force on SIDS. “If you do fall asleep, as soon as you wake up be sure to move the baby to his or her own bed.”

Led by Georgetown faculty from the National Center for Education in Maternal and Child Health (NCEMCH) and the National Center for Cultural Competence, NAPPSS will bring together more than 60 national organizations that impact families with infants to develop strategies to support both breastfeeding and safe sleeping.

“This means moving beyond telling families what they should do — with guidelines full of do and don’t lists— to offering them information about why the recommendations are offered and ways to achieve both goals,” Bronheim said. “It is not only about delivering the ‘correct message,’ but about empowering families with information to make their own decisions.”

Taking a conversations approach to safe sleep and breastfeeding not only gives parents the information they need – it also helps build their confidence.

“In addition to having a positive view of safe sleep and breastfeeding and accurate information, families need to have a sense of self-efficacy—the knowledge, skills and resources to implement risk-reduction behaviors and this is best achieved in conversations with individual families,” Bronheim said.

NAPPSS is funded through a cooperative agreement for $1.5 million over three years to NCEMCH from the Maternal and Child Health Bureau of the Health Resources and Services Administration at HHS. In addition to Georgetown faculty, NAPPSS is led by members from First Candle, a safe sleep advocacy and support organization and the United States Breastfeeding Committee, the national breastfeeding coalition and primary implementation partner of The Surgeon General’s Call to Action to Support Breastfeeding.

Kat Zambon
GUMC Communications