The Relationship Between Diaper Insecurity and Safe Infant Sleep Practices: A Prospective Survey of Kansas Birthing Persons

Safe sleep practices, including use of sleep-appropriate clothing, are crucial for reducing sleep-related deaths. Diapers are part of infant sleepwear, but many caregivers cannot afford them. This study explored diaper insecurity and safe sleep practices, with secondary assessment of social health factors. A 34-question survey examined infant sleep practices, diaper insecurity, and social determinants of health among birthing persons in Kansas who received safe sleep education. Of respondents, 69% (n = 78/113) experienced diaper insecurity, with affected infants being older (6.8 vs 5.3 months, <i>P</i> = .026), non-Hispanic (<i>P</i> = .049), and on Medicaid (<i>P</i> = .018). No significant difference in sleep practices was found. Diaper-insecure participants were more likely to report housing insecurity (<i>P</i> = .029), food insecurity (<i>P</i> < .001), childcare difficulties (<i>P</i> = .007) and financial insecurity (<i>P</i> < .001). These findings showcase the need for screening and interventional support for diaper insecurity, especially for families experiencing challenges related to social health factors, receiving Medicaid, and/or with infants over 6 months old.