0932 When Bed Sharing Becomes the Only Way: Understanding Black Mothers’ Lived Realities of Sleep in Delaware

Abstract Introduction Unsafe sleep environments are the leading cause of death for U.S. infants between one month and one year of age. In Delaware, approximately one infant dies every month due to unsafe sleep conditions, with Black infants making up to 63% of unsafe sleep deaths. Black mothers’ choices around their baby’s sleep are often stigmatized and dismissed. Therefore, this study aimed to understand Black mothers’ experience and decisions around getting their baby to fall and stay asleep in Delaware. Methods We conducted focus groups with Black mothers of infants and toddlers across Delaware counties (New Castle N=6, Dover N=7, Sussex N=7). Mothers were asked about what sleep strategies they used to get their baby to fall and stay asleep, what additional support they have or need, how their own childhood sleep experiences inform their approach to infant sleep, and what social messaging affects their decisions about their baby’s sleep? We used qualitative content analysis to analyze the focus group data. Results Mothers were mean age (28.79 years, SD=5.23), 53% were single/never married, 32% held a Bachelor’s degree or higher, 74% were enrolled in government-funded assistance programs, and 90% were breastfeeding or had breastfed in the past. Every mother stated that despite knowing national safe sleep guidelines, they chose to bedshare with their infant since birth, and none had divulged this information to their pediatrician. All mothers indicated that their decision to bedshare was accompanied by an emotional reaction including fear, guilt and shame. Mothers did not report bedsharing as a cultural practice, but as the only strategy that facilitated baby sleep, frequently in conjunction with breastfeeding. Mothers discussed having limited support and hesitancy to rely on their village, often in the context of their own chaotic childhoods. Conclusion Black mothers are choosing to bedshare with their infants, despite facing judgment from family, providers and partners. Mothers viewed bed sharing and breastfeeding (often in combination) as the only successful strategy in getting their baby to sleep. Future work must empower Black mothers to make informed decisions around their baby’s sleep. Support (if any) The Gordon and Betty Moore Foundation, through Grant GBMF9048.