In the 10 years after the introduction of the Back to Sleep campaign in 1994, the rate of Sudden Infant Death Syndrome in the U.S. dropped by 53 percent as the practice of supine sleeping grew from 10 to 78 percent. But a new study, "Factors Associated with Choice of Infant Sleep Position," in the September 2017 issue of the journal Pediatrics (published online Aug. 21), finds that more than half of parents still sometimes place their babies to sleep in the prone or side position.

Of the 3,297 mothers recruited from 32 U.S. hospitals for research, 77.3 percent reported they usually placed their infants on their backs for sleep, but fewer than half reported that they exclusively did so. Some communities were found to be more resistant to the back–to–sleep message. Black mothers and those who did not complete high school were more likely to intend to use the prone position. Those who had positive attitudes towards the prone position had more than 100 times the odds of intending to use that position, which shows that there are great opportunities for educational interventions. Position changes are of particular concern given studies showing that infants who are unaccustomed to prone (stomach) sleeping are especially at risk when placed in that position.

Researchers concluded that while families have received the message that babies should be put on their backs to sleep, many don't follow through, and that more research is needed to find and test the best educational programs to get more parents to exclusively put their babies to bed on their backs.