Awareness of infant safe sleep messages and associated care practices: findings from an Australian cohort of families with young infants.

Objective: To investigate primary infant caregiver awareness of the current national public health safe sleep messages and the associations of awareness with care practices. Design and setting: A cross-sectional survey in Queensland, Australia. All families with live babies birthed during April-May 2017 were eligible. Questionnaires were distributed when infants were approximately 3 months old. Participants: Of the 10 200 eligible families, 3341 (33%) primary caregivers participated. Main outcome measures: Participants were asked: to recall key safe sleeping messages they were aware of (unprompted); questions about their infant care practices; and to select the current, national six safe sleeping messages (prompted multi-choice). Results: Overall, the majority of families are aware of sleep-related infant mortality and sudden infant death (3178/3317, 96%); however, approximately one in four caregivers (867/3292, 26%) could not identify the current six messages to promote safer infant sleep in a multi-choice question. Despite being aware of the six key messages, some caregiver practices did not always align with advice (336/2423, 14% were not smoke-free; 349/2423, 14% were not usually supine for sleep; 649/2339, 28% employed practices which may increase risk of head or face covering; 426/2423, 18% were not receiving breastmilk). Conclusions: There is considerable scope for improvement in parent awareness and ability to recall key safe sleep messages. Awareness of advice does not always translate into safe infant care. Health promotion messaging to encourage safer infant sleep, ultimately aimed at reducing sudden unexpected infant deaths, needs more effective supportive strategies and dissemination if future campaigns are to be successful.