255 - Intended Bedsharing with Infants and Associated Factors Among Pregnant Persons with Low Income

Publication Number: 255.5500

Ann Kellams, University of Virginia, Charlottesville, VA, United States; Fern R. Hauck, UVA, Charlottesville, VA, United States; Stephen Kerr, BU, Boston, MA, United States; Rachel Y. Moon, University of Virginia School of Medicine, Charlottesville, VA, United States; Margaret Parker, UMass Memorial Children's Medical Center, Worchester, MA, United States; Eve R.. Colson, WashU Medicine, Saint Louis, MO, United States

Background: Infant sleep location has significant health implications for the infant. While roomsharing without bedsharing is recommended by AAP as the safest, bedsharing is associated with increased breastfeeding, which is also recommended for protection against Sudden Infant Death Syndrome (SIDS). Little is known about prenatal intention for bedsharing with infants.

Objective: To determine the rates of and factors associated with prenatal intention for infant bedsharing.

Design/Methods: Lower income English- and Spanish-speaking pregnant people (n=1258) recruited through WIC and federally-qualified health centers in 17 states in Jan 2022-Oct 2024 were surveyed at 32-34-weeks’ gestation as part of a RCT to promote breastfeeding and safe sleep, prior to receiving any intervention. We asked participants to “Check all the locations you plan to place your baby for sleeping and napping in the first month at home. (Include sleeping or napping at any time of the day or night).” A logistic regression model examined sociodemographic characteristics associated with any intended bedsharing vs. none.

Results: Of 1258 pregnant people surveyed, 104 (8.3%) reported that they intended any bedsharing. Those more likely to intend bedsharing self-described as non-Hispanic Black compared to Non-Hispanic White (ref) (aOR 1.79; 95% CI 1.04,3.09) and Spanish-speaking (aOR 2.71; 95% CI 1.04, 7.04). People with >college education compared to < high school had a higher intent to bedshare (aOR 3.18; 95% CI 1.20, 8.43), There was no significant difference in intent to bedshare among people planning any breastfeeding (8.6%) compared to those planning to feed formula only or who were unsure (5.8%).

Conclusion(s): Among this low-income sample of US pregnant people, intent to bedshare with their infants was low, despite studies demonstrating that postnatally, rates of bedsharing are significantly higher. Higher intent to bedshare was found among non-Hispanic and Spanish speaking pregnant people and higher intent found among those with higher education. Further information is needed to explain persistent racial disparities and the complex relationships between social determinants of health, bedsharing, and breastfeeding. The RCT will determine if actual bedsharing rates are higher than intended, determine whether a safe sleep or breastfeeding intervention makes a difference, and provide more information about reasons for changes from intent to bedshare.