Grandparent caregivers unaware of more recent safety and other recommendations

The number of grandparent caregivers continues to grow, and while these older adults may be experienced in caring for young children, many are unaware of more recent safety and other recommendations - including those related to appropriate child sleep position, crib safety, car seat and walker use, according to research presented Oct. 21 at the American Academy of Pediatrics (AAP) National Conference and Exhibition in New Orleans.

According to the 2011 American Community Survey, an estimated 2.87 million grandparents are the primary caregivers to their grandchildren - a nearly 20 percent increase since the year 2000. In the study, "Grandparent Caregiver Knowledge of Anticipatory Guidance Topics," researchers attended regularly scheduled Grandparent/Kinship Care support groups. Forty-nine participants completed a 15-question survey that addressed common pediatric safety and anticipatory guidance topics for children of all ages.

When asked, "What is the best position for a baby to sleep in?" 33 percent of respondents chose "on the stomach;" 23 percent, "on the side;" and 43.8 percent, "the back." The AAP recommends that infants be placed to sleep on their backs to prevent Sudden Infant Death Syndrome (SIDS). When asked about correct car seat positioning, 24.5 percent responded that a 22 pound, 9 month-old child should be facing forward, and yet the AAP recommends that children remain in a rear-facing car seat until age 2.

Last year, the AAP recommended that bumpers, stuffed animals and blankets be removed from infant cribs, and yet 49 percent of grandparent caregivers thought these items were acceptable. Nearly 74 percent respondents stated that a walker is a good device to help babies learn to walk. The AAP does not recommend walker use, and in fact urges caregivers to dispose of them because of serious safety concerns.

"Pediatric health and safety recommendations are constantly evolving," said study author Kathryn C. Hines, MD, a University of Alabama at Birmingham physician who sees patients at Children's of Alabama. "Many recommendations are likely to have changed since these grandparent caregivers parented their own children."

"Discussion of health and safety recommendations is an essential part of routine well-child care, and pediatricians must recognize knowledge deficits that may exist in grandparent caregivers and be comfortable addressing these deficits," said primary study author Amanda Soong, MD, FAAP, also of UAB.