The Impact of Maternal Worry on Infant Care Practices

Objectives: Examine the 1) prevalence of worries among US mothers of infants; 2) association between worries and American Academy of Pediatrics recommended infant care practices (breastfeeding, supine sleep, roomsharing without bedsharing); 3) association of maternal and household characteristics with worries. Methods: We analyzed a nationally representative sample of 3165 mothers who were surveyed regarding safe sleep and breastfeeding when infants were 2 to 6 months of age in 2011–2014. We examined the prevalence of 8 maternal worries (housing, job, income, neighborhood, family relationships, health, baby's health, family member health). We used multivariable logistic regression to examine associations of A) both overall number of worries and individual worries with each infant care practice; and B) maternal and household characteristics with worries. Results: Twenty-six percent of mothers reported 0 worries, 26% reported 1–2 worries, 23% reported 3–4 worries, and 25% reported 5–8 worries. Compared to those with 0 worries, mothers with 5–8 worries had increased odds of bedsharing (adjusted odds ratio = 1.60 [1.19–2.14]) and non-supine sleep (aOR = 1.37 [1.07–1.74]). Specific worries associated with increased odds of bedsharing included: housing (aOR = 1.39 [1.09–1.78]), income (aOR = 1.35 [1.09–1.67]), neighborhood (aOR = 1.37 [1.05–1.78]), family relationships (aOR = 1.43 [1.10–1.86]), and health of a family member (aOR = 1.24 [1.06–1.46]). Maternal worries were not associated with infant feeding practices. Conclusions: We found a high prevalence of worries regarding basic needs, family relationships, and health among US mothers. Greater total worries and several individual worries were associated with higher odds of bedsharing. The “cognitive load” of maternal worries may impact adherence to safe sleep practices and requires further investigation.