Supporting culturally valued infant care practices in high risk infant sleep environments: trial of a safe sleep enabler

Background: Aboriginal and Torres Strait Islander babies are 3.8 times more likely to die suddenly and unexpectedly than non-Indigenous infants. Sleeping with a baby is a common infant care practice particularly for breastfeeding infants, and the cultural norm in Indigenous communities. However infant deaths are associated with co-sleeping in hazardous circumstances; particularly for preterm or low birth weight babies or where smoking, alcohol, drug use or unsafe sleep environments are present (1). The use of portable sleep spaces to reduce the risk of Sudden Unexpected Death in Infancy (SUDI) for families with identified risk factors has not been previously reported in Australia. Indigenous communities have identified this area as a priority for investigation (2) following successful trials of a safe sleep enabler in some Maori communities in Christchurch, New Zealand (3). Aim: The purpose of this study was to determine the acceptability and feasibility of the Pēpi-pod Program, a portable infant sleep space embedded within safe sleep health promotion, within Aboriginal and Torres Strait Islander families from six Queensland communities. Methods: An exploratory descriptive design was used to report parent experiences (target n=100) of using the Pēpi-pod Program to support safe infant sleep. Families were selected through six health services which provide antenatal and maternity care services to Aboriginal and Torres Strait Islander families, and include metropolitan, rural and remote areas of Queensland. Eligible participants were parent/s and/or carers of a baby (ideally