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Observed non‐compliance with safe sleeping guidelines in licensed home‐ and centre‐ based childcare services
Abstract   Peer reviewed

Observed non‐compliance with safe sleeping guidelines in licensed home‐ and centre‐ based childcare services

S Staton, A Pease, S Smith, C Pattinson, P Blair, Jeanine Young, S Irvine and K Thorpe
Journal of Sleep Research, Vol.27(Supplement 2), pp.18-19
Annual Scientific Meeting of Australasian Sleep Association and the Australasian Sleep Technologists Association, 30th (Brisbane, Australia, 17-Oct-2018–20-Oct-2018)
2018
DOI: https://doi.org/10.1111/jsr.37_12765
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https://doi.org/10.1111/jsr.37_12765View
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Abstract

Medical and Health Sciences Psychology and Cognitive Sciences
Introduction: Approximately a quarter of sleep-related deaths in infancy occur outside the home, many in childcare settings. This study sought to independently assess the extent to which licensed childcare services comply with safe sleeping guidelines and explore underlying explanations for non-compliance. Methods: Standard observations were undertaken in a representative sample of infant rooms in Australian licensed childcare services (n = 18; 15 centre-based, 3 home-based) all subject to national regulation and legislation to comply with safe sleeping guidelines. Observations occurred across a childcare day to capture all sleep-related practices. Surveys were completed by lead educators in observed rooms (n = 31) providing data on educator characteristics, and on each individual's knowledge, beliefs and attitudes regarding safe sleeping practices. Results: 83% of childcare services were observed to be non-compliant on at least one of 20 target guidelines (median 2.5, Max = 7); 44% were observed placing infants prone/side and 67% used loose bedding, quilts, doonas/duvets, pillows, sheepskins or soft toys in cots. Services with younger infants in attendance were more likely to place infants to sleep prone/side. Exploratory analyses suggested a possible cohort effect. Educators who had entered the childcare workforce prior to, or during, the initial back-to-sleep campaign in the early 1990s were compliant with the guideline to place an infant supine. Discussion: Despite 25 years of public health messaging, non-compliance with safe sleeping guidelines remains high in childcare services. Risk salience is identified as a focus for explaining noncompliance and warrants detailed investigation in larger samples. The role of recent legislative changes, requiring all licensed childcare services to have a written policy and procedure for sleep and rest, in increasing compliance to Safe Sleeping Guidelines will be discussed.

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