“Back to sleep”: parents compliance with the recommendation on the most appropriate sleeping position of infants, Haifa District, Israel, 2001

Background In 1993, the Israel Ministry of Health issued a formal recommendation to avoid placing healthy infants to sleep in the prone position in order to prevent sudden infant death. The objective of the study was to study parentsʹ compliance with this recommendation and to identify characteristics of noncompliant parents of infants aged less than 6 months old. Methods The study population consisted of 1912 parents of infants aged 0–12 months who visited the Haifa District primary preventive health centers during the study week and answered the self-administered questionnaire. Results 15.6% of infants younger than 1 year were placed to sleep in the prone position: 12.4% among infants younger than 3 months, and 17.6% among infants 3–6 months old. Surprisingly, multiple logistic regression analysis demonstrated that Israeli-born Jewish mothers were more likely to place their babies prone than Israeli-born Arab mothers or mothers born in the former Soviet Union who had immigrated to Israel after 1990. Conclusions At-risk behaviors are usually associated with minority and immigrant populations. Culture specific and other possible reasons for our unusual findings are discussed.