655 - Listening to Mothers: Insights on Safe Sleep Education in the NICU to Inform an Intervention

Publication Number: 4641.655

Eve Colson, Washington University School of Medicine, St Louis, MO, United States; Peyton Rieger, University of Virginia School of Medicine, Charlottesville, VA, United States; Rachel Moon, University of Virginia School of Medicine, Charlottesville, VA, United States; Laura Crook, Washington University in St. Louis School of Medicine, St. Louis, MO, United States; Lauren Nacke, Washington University in St. Louis School of Public Health, St. Louis, MO, United States; Mackenzie Cunningham, Washington University in St. Louis School of Medicine, Saint Louis, MO, United States; Margaret Parker, UMass Chan School of Medicine, Worcester, MA, United States; Genevieve Guyol, Boston University School of Medicine, Boston, MA, United States; Sunah S. Hwang, University of Colorado School of Medicine, Denver, CO, United States; Nicole Geller, Boston University, Boston, MA, United States; Bryanne N. Colvin, Washington University in St. Louis School of Medicine, Saint Louis, MO, United States

Background: Preterm infants have a higher risk of Sudden Unexpected Infant Death (SUID) than those born full-term, and their caregivers have high rates of nonadherence to infant safe sleep recommendations. Prolonged Neonatal ICU (NICU) stays create a unique opportunity for parents to receive safe sleep education before discharge.

Objective: To identify facilitators and barriers to and strategies for implementation of effective safe sleep education in the NICU through discussions with mothers of preterm infants.

Design/Methods: From April to October 2025, we conducted semi-structured interviews with English-speaking mothers of preterm infants. We purposefully sampled mothers 2-5 months after their infants were discharged from 4 NICUs across the US. We used a rapid qualitative approach to identify facilitators and barriers to, and strategies for the implementation of effective safe sleep education. Interviews introduced AAP NICU-specific safe sleep recommendations and then asked questions about the education they received in the NICU about safe sleep, how well that worked, content they recommend, and strategies for implementation. Interviews were transcribed and analyzed for common themes. Institutions had IRB approval.

Results: Nineteen mothers of preterm infants were interviewed. (Table) Participants shared facilitators for effective education, including receiving the education early in the NICU stay, continuous discussion of safe sleep during the stay, and direct conversations with hospital staff (as opposed to only written materials.) Barriers to effective education included content gaps, such as how to address reflux. Many would have appreciated emphasis on how to effectively practice sleep recommendations when transitioning to home given significant environmental differences. Several participants also discussed needing anticipatory guidance for addressing self-doubt and guilt when attempting to adhere to safe sleep practices at home. Several mothers also suggested providing education in a variety of ways such as videos via a QR code, especially useful if they cannot be at the bedside. They also endorsed placing safe sleep information around the unit in visible locations for all to see.

Conclusion(s): Mothers of preterm infants gave important insights about facilitators and barriers to and strategies for implementing effective NICU safe sleep education, which will be used to inform the design of a safe sleep educational intervention in the NICU.

Table: Participant Demographics
10_30_25Table .pdf