Each year, 4,000 babies die unexpectedly during sleep time from sudden infant death syndrome, accidental suffocation, or unknown causes. To keep infants safe, the American Academy of Pediatrics advises caregivers to put babies to sleep on their backs and avoid sharing a bed, among other practices.

Many families, however, are not following this advice, according to a study presented May 3 at the Pediatric Academic Societies (PAS) annual meeting in Vancouver, British Columbia, Canada.

Researchers surveyed a nationally representative sample of 1,030 mothers recruited from 32 hospitals across the country: 61% of the mothers were white, 13% were black, and 25% Hispanic;  57% were married; and 8% were 14-19 years old, 24% were 20-24 years, 29% were 25-29 years, and 36% were age 30 or older.

When infants were 2 to 6 months of age, mothers completed an online or telephone survey asking about infant care practices, including bed sharing and infant sleeping position. Results showed families do not always follow recommendations to reduce the risk of sleep-related infant death. In addition, high-risk sleeping behaviors, such as bed sharing and putting infants on their stomachs to sleep, are more common among black and Hispanic families.

Overall, 18.5% of mothers reported sharing a bed with their infant. The rate was highest among Hispanics (28%) followed by blacks (18.4%) and whites (13.7%).

About 10% of all mothers routinely put their babies to sleep on their stomachs. The rate was highest among blacks (21.6%) followed by whites (10.4%) and Hispanics (7.1%).

“There appears to be more that can be done to provide safe environments for infants while they sleep,” says lead author Eve R. Colson, MD, MHPE, FAAP, professor of pediatrics, Yale University School of Medicine, in a release.

Colson presented “Reports of Infant Sleep Behaviors from a National Sample of Mothers: the Study of Attitudes and Factors Affecting Infant Care (SAFE).

This study was supported by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development.