Use of Practices to Reduce of Sudden Unexpected Infant Death among Caregivers of Opioid Exposed Newborns

Objectives: Sudden unexpected infant death (SUID) occurs disproportionately among opioid exposed newborns (OENs) compared to those unexposed. The extent that primary caregivers of OENs adhere to SUID-reducing infant care practices is unknown. We examined rates of SUID-reducing practices (smoking cessation, breastfeeding, and safe sleep [supine sleep, room-sharing not bed-sharing, nonuse of soft bedding or objects]) in a pilot sample of caregivers of OENs. Methods: We surveyed 50 English-speaking mothers and other primary caregivers of OENs 1–6 months old between 02/2022 and 10/ 2023. We examined prenatal and postnatal cigarette smoking exposure, breastfeeding initiation and duration, and sleep position (side, back, or stomach), sleep location (bed-sharing, room-sharing not bed-sharing, or separate room), and soft bedding or objects in the infant sleep space. Results: Thirty-six (72%) of 50 respondents were birth mothers and 14/50 (28%) were other caregivers. Sixty-one percent of infants were exposed to cigarette smoking prenatally (mothers only) and 34% postnatally (41% mothers vs 14% other caregivers). Sixty percent of infants received breast milk ≤4 weeks. Among respondents, 32% placed infants in nonsupine sleep position (36% mothers vs 21% other caregivers), 38% shared a bed with their infant for sleep (47% mothers vs 14% other caregivers), and 30% used soft bedding in the infant sleep space (33% among mothers vs 21% among other caregivers). Conclusions: Infant care practices associated with SUID were highly prevalent in our pilot sample of OENs and differed among mothers versus other caregivers. Further investigation and tailored approaches to this population are needed.