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Title: Infant activity and sleep behaviors in a maternal and infant home visiting project among rural, Southern, African American women

Author
item Thomson, Jessica
item TUSSING-HUMPHREYS, LISA - University Of Illinois
item Goodman, Melissa
item LANDRY, ALICIA - University Of Central Arkansas

Submitted to: Maternal Health, Neonatology, and Perinatology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 3/13/2018
Publication Date: 5/16/2018
Citation: Thomson, J.L., Tussing-Humphreys, L.M., Goodman, M.H., Landry, A.S. 2018. Infant activity and sleep behaviors in a maternal and infant home visiting project among rural, Southern, African American women. Maternal Health, Neonatology, and Perinatology. 4:10. https://doi.org/10.1186/s40748-018-0078-0.
DOI: https://doi.org/10.1186/s40748-018-0078-0

Interpretive Summary: Early excessive weight gain in infancy leads to increased risks of childhood and adult obesity, notably in African Americans. Two potential causes of excessive weight gain in infants is physical inactivity and inadequate amounts of sleep. Thus, it is important for parents and caregivers of infants to recognize the need for decreasing sedentary behavior and increasing unrestrained floor time, as well as to ensure that infants are getting recommended amounts of sleep. The primary objectives of this study were to determine if mothers who participated in a maternal, infant, and early childhood home visiting project improved their knowledge and beliefs concerning child activity and sleep and if these mothers were compliant with expert recommendations for infant sleep. Pregnant women at least 18 years of age, less than 19 weeks pregnant, and residing in three Mississippi counties were recruited between March 2013 and December 2014. Postnatal data was collected from 54 mothers between September 2013 and May 2016. Maternal knowledge and beliefs significantly improved for two recommendations – correct infant sleep position (back) and beginning tummy time by one month of age. Additionally, as infants became older, they were more likely to meet expert recommendations for amounts of sleep. However, only 20% of mothers were compliant with the back to sleep recommendation for the first year of their infant’s life with average time to noncompliance approximately 8 months. Baseline knowledge concerning infant activity and sleep recommendations was generally high in this group of rural, Southern, African American mothers. However, compliance with recommendations was not optimal suggesting the need for further intervention.

Technical Abstract: Background: Physical inactivity and inadequate amounts of sleep are two potential causes for excessive weight gain in infancy. Thus, parents and caregivers of infants need to be educated about decreasing infant sedentary behavior, increasing infant unrestrained floor time, as well as age specific recommended amounts of sleep for infants. The aims of this study were to determine if maternal knowledge about infant activity and sleep changed over time and to evaluate maternal compliance rates with expert recommendations for infant sleep in a two-arm, randomized, controlled, comparative impact trial. Methods: Pregnant women at least 18 years of age, less than 19 weeks pregnant, and residing in a lower Mississippi Delta county were recruited between March 2013 and December 2014. Postnatal data was collected from 54 participants between September 2013 and May 2016. McNemar’s test of symmetry was used to determine if maternal knowledge changed over time, while generalized linear mixed models and Kaplan-Meier survival curves were used to assess compliance with expert recommendations for sleep. Results: The postnatal retention rate was 85%. Maternal knowledge significantly increased for correct infant sleep position (back) and beginning tummy time by one month of age. Odds of meeting sleep duration recommendations increased by 30% for every one month increase in infant age. Only 20% of the participants were compliant with the back to sleep recommendation for the first 12 months of their infant’s life; median time to noncompliance was 7.8 months. Although baseline knowledge concerning infant activity and sleep was high in this cohort of rural, Southern, African American mothers, compliance with recommendations was not optimal.