Vol. 75 - No. ?? MiNerVa Pediatrics 1 LETTERS TO THE EDITOR © 2023 ediZiONi MiNerVa Medica Online version at https://www.minervamedica.it Minerva Pediatrics 2023 Feb 09 dOi: 10.23736/s2724-5276.23.07182-3 Parental perception of sids prevention measures: where are we at? Focusing on the intrinsically fragile context of the frst months of life, the american academy of Pediatrics (aaP) released recent guidelines on sudden infant death syndrome (sids) prevention measures. 1 Specif- cally, aaP recommended a safe sleep environment to reduce the risk of all sleep-related deaths. 1 this advice focused on the importance of putting the infant sleep- ing on the back and using cardboard boxes as a sleep lo- cation, utilizing a non-inclined and frm sleep surface, sharing the room without bed-sharing, using the paci- fer, giving importance to breastfeeding, tummy time, and routine immunization. 1 On the other hand, aaP advised the avoidance of soft bedding and overheat- ing exposure to nicotine, alcohol, marijuana, opioids, and illicit drugs, and home cardiorespiratory monitors. 1 although sids has declined in countries that have ad- opted policies encouraging non-prone sleeping, it still represents one of the leading causes of death for infants below one year in the richest countries. 2 despite re- ported awareness of aaP guidelines, discrepancies be- tween knowledge and practice exist in the medical and nursing community. Specifcally, nurses could have an uncertain attitude towards sleep positioning, and 21% of nurses admitted that they did not include information regarding sids prevention. 2 in general, personal be- liefs, lack of knowledge, and imperception of risks are the main barriers to implementing guidelines for care- givers. 3, 4 to investigate parents’ knowledge of sids prevention measures, we performed a retrospective, de- scriptive study regarding all parents of full-term new- borns who attended our neonatal care unit between 25 th July and 25 th September 2022. Specifcally, data about sids prevention measures according to aaP-2022 guidelines 1 was obtained from the patient’s medical re- cords. stata software (version 16) for Windows was used for statistical evaluation. the normality of the data distribution was tested using the Kolmogorov-smirnov test. the r-spearman test was applied to study the association between demographic features and knowl- edge about sids prevention measures. Parents were ad- equately informed about crib location (69.5%), avoid- ance of smooth bedding and dangerous accessories in baby’s bed (73.4%), prenatal and postnatal exposure to tobacco (71.7%), to alcohol or other illicit substances (69.1%). On the other hand, many parents were not aware of the use of home cardiorespiratory monitors (11.3%) and pacifers (18.2%), immunizations (31.7%), tummy time (14.3%), avoidance of swaddling (23.9%). the male gender (P<0.05; ci: 0.002-0.264), “african” or “asian” ethnicity (P<0.001; ci: 0.253-0.483), and low educational degree (P<0.001; ci: -0.381 to -0.132). were associated with a higher percentage of the wrong adoption of sids prevention measures. Gamble et al. 5 showed that expecting women had low and stackable knowledge about the preventive effect of immunization (32.7%), pacifer use (16.3%), and risk factors related to the infant (2.4%). On the other hand, the knowl- edge of the prevention measures during breastfeeding (35.6%) and the use of bed accessories (32.7%) was lower than our cohort. about the gender, our analysis lines up with Hirsch et al. 3 Specifcally, in the context of male caregiver’s practices, this male cohort followed adequate indications on safe sleep locations (57%) and supine positioning (42%) more likely than those on un- cluttered bed environment (26%). in addition, adher- ence to safe sleep guidance is less effective in social and low-income families. crane et al. 4 used the Paki- stani community of a northern UK city as a model and showed that sids intervention strategies were lim- ited in this subgroup because of their cultural beliefs. spencer et al. 6 demonstrated an increased risk of sids with greater exposure to adverse social circumstances. this study was subjected to multiple limitations. First, the small simple size; second, data were collected in a single neonatal care unit. third, data were self-reported by the parents of newborns. in conclusion, it was pos- sible to defne an “at-risk population” involving male, african/asian, and poorly educated parents unaware of sids and its prevention measures. Our study could help pediatricians, nurses, and obstetrics to identify a specifc subgroup of parents that could beneft from tai- lored information related to sids prevention measures in the context of birthing classes, neonatal care units, and counseling centers. Luca PecOrarO 1 *, carolà P aNZeri 1 , Fulvio Nisi 2 , silvana LaUriOLa 1 , Giorgio PiaceNtiNi 1 , angelo PietrOBeLLi 1, 3 1 Unit of Pediatrics, department of surgical sciences, dentistry, Gynecology, and Pediatrics, University of Verona, Verona, italy; 2 irccs Humanitas clinic, rozzano, Milan, italy; 3 Pennington Biomedical research center, Baton rouge, La, Usa COPYRIGHT © 2023 EDIZIONI MINERVA MEDICA This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one fle and print only one copy of this Article. It is not permitted to make additional copies (either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet fle sharing systems, electronic mailing or any other means which may allow access to the Article. 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