The South Australian Pepi-Pod® program – culturally safe sleep for Aboriginal babies

Purpose Closing the gap in health outcomes between Aboriginal and Torres Strait Islander and non-Indigenous infants is most significant in incidences of sudden infant death syndrome. This study reports on the implementation of the Pepi-Pod® program, which promotes safe sleeping of Aboriginal infants and provides a safe sleep surface for the baby (the Pepi-Pod®), accompanied by safe sleep health messaging. Design/methodology/approach This study adopted a decolonising, qualitative approach and used yarning to gather data on the effectiveness and acceptability of the project, and data were thematically analysed by Aboriginal researchers. The study was conducted at regional and metropolitan birthing centres in Australia, with 44 Aboriginal families participating. Findings Three themes emerged from the data: (1) yarning with family and community about safe sleeping; (2) reflecting Aboriginal cultural practices and (3) shame job – “are you sleeping your baby in a plastic box?” Participants recommended improvements, including cultural changes in design and colour of the Pepi-Pod® but overall viewed the program as a culturally appropriate experience. Research limitations/implications This study employed qualitative methods grounded in Yarning and a culturally safe, decolonising approach – yielding rich, authentic data and amplifying Aboriginal voices without bias. Expert consultation was central, with Aboriginal and Torres Strait Islander researchers, consumer representatives and clinicians ensuring cultural and ethical integrity. However, the study was limited to South Australia, which may affect generalisability. COVID-19 disruptions also delayed data collection and project completion. Despite these constraints, the research offers valuable insights into culturally safe infant sleep practices and highlights the importance of inclusive, community-led approaches in maternal and family health research. Practical implications This novel study has the potential to change safe sleep policy and knowledge arising from this project may influence how health services and systems deliver culturally safe health messaging and implement new programs involving and affecting Aboriginal families in mainstream health care. Social implications This research introduced the only alternative safe sleep education and surface specifically designed for and offered to Aboriginal and Torres Strait Islander families in Australia. By addressing both safety and cultural relevance, it highlights the importance of equitable access to infant health interventions that respect and incorporate Indigenous perspectives. Originality/value This study contributes meaningful and practical solutions to the longstanding challenge of ensuring safe sleep environments for infants, particularly within Aboriginal communities. By foregrounding cultural safety and community engagement, it offers a unique and contextually relevant approach that bridges public health priorities with Indigenous knowledge and values.