Abstract □ 153

Introduction :Sleeping in supine position was shown to be effective in declining SIDS. Despite large media campaigns and efforts by individual (para)medical personnel to change previous sleeping habits, some infants are still being put in a prone or side sleeping position.

Study design : Every infant presenting at the polysomnography unit during the period 14/01-14/11/97 was included in this prospective study. For the infants sleeping in a non-conventional position (e.g. prone or side), a questionnaire about the current sleeping and health status was completed. Afterwards, the importance of supine sleeping was stressed to the parents. One month later, the parents were contacted by the social nurse to assess the sleeping position at that moment. The results were calculated for "inborn" patients (= born in Virga Jessehospital) and for "outborn" patients (= born in other hospitals). In the former hospital a strict protocol about supine position at the maternity unit was introduced after instructions to the nursing staff since november 1992. In each room a note with the current sleeping recommendations is present. Parents are furthermore personally informed by a pediatrician and a nurse.

Results : In the study population (n = 752; 37.8 % inborns) the percentage supine sleepers was 79.3 %. Prone and side sleeping were reported in 7.4 (n = 56) and 13.3 (n = 100) % resp. An important difference in prevalence of the different sleeping positions was seen among the different hospitals at birth. 93 % of the inborn babies slept in a supine position whereas only 73 % of the outborns (p < 0.001). No differences in prevalence of prematurity, important gastro-oesofageal reflux or colics were seen according to the sleeping position. One month after the intervention, 76 of the 100 side sleepers slept on the back. 22 of the 56 prone sleepers were put on the back and 4 on the side (4 unknown). All parents declared having changed the sleeping position because of the medical explanation. Contrary to their expectations, the sleeping attitude was easily changed. Parents experienced their babies to sleep less deep, what gave them a secure feeling. The 28 parents still putting their baby in a prone position despite the secondary medical intervention, gave the following reasons : sleeping comfort, unbelief about the relationship SIDS/sleeping position, impossibility to put the baby to sleep in a supine position, superficial sleeping pattern of the baby.

Conclusions : Prone and side sleeping is still present in 20.7% of the tested population. A uniform guideline at the maternity unit seems to improve the prevalence of supine sleeping. After secondary (para)medical intervention for infants sleeping in a non-conventional position, 40.4 % of the prone sleepers and 76.6% of the side sleepers were put in a supine position. The medical explanation was for the parents the most important reason. The change in sleeping position was easier than initially thought. The infants were found to have a more superficial sleeping pattern.