By Fran Lowry

NEW YORK (Reuters Health) Oct 23 – Grandparents who look after young children often lack knowledge about current recommendations on topics such as sleep and crib safety and infant care, which have changed since they first parented their own kids, researchers said in New Orleans Sunday at the American Academy of Pediatrics (AAP) National Conference and Exhibition.

The number of grandparent caregivers has been increasing since the 1990s, and has increased 12.5% in the last decade alone. Their current estimated number is a little over 2.7 million, Dr. Amanda Soong, from the University of Alabama at Birmingham told Reuters Health.

“UAB was awarded a grant from the Donald W. Reynolds Foundation to improve geriatric education and part of our program was to improve awareness among our pediatric trainees of the growing number of grandparent caregivers,” Dr. Soong said.

“We wanted to evaluate what knowledge deficits might exist among these older caregivers. I had my first child about the time I became involved in this project and I thought it would be interesting to see how much had changed as far as safety recommendations go, especially after reading a parenting book my mom had received at the time of my birth.”

Dr. Soong and her group met with grandparent and kinship care groups in the Birmingham metropolitan area and asked participants to complete a 15-question survey about common pediatric safety and anticipatory topics for children of all ages.

Forty-nine participants completed the survey.

When asked what is the best position for a baby to sleep in, 33% chose on the stomach, 23% chose on the side, and 43.8% chose on the back.

When asked about correct car seat positioning, 24.5% responded that a 22-pound nine-month old should be facing forward. (The AAP recommends that children be placed in rear-facing seats until age two.)

With regard to sleep safety, 49% of respondents believed that infant beds should contain bumpers, stuffed animals, and blankets in addition to mattresses and sheets, while only 26.5% believed the crib should contain just a mattress with a sheet. (The AAP advises against bumpers, stuffed animals, and blankets.)

Finally, 73.9% of respondents believed that a walker is a good device to help babies learn to walk. (The AAP advises against baby walkers because of serious safety concerns.)

“Ideally, pediatricians should be providing all routine guidance to older caregivers as they would to new parents,” Dr. Soong said.

She acknowledged that this can be difficult as grandparents “obviously” have prior parenting experience.

“Pediatricians need to be respectful of grandparents’ experiences, while providing important safety information that could significantly impact the child’s health.”

She added that physicians should never assume that even parents know current guidelines.

“Each parent and grandparent, despite parenting experience, should be reminded of the most recent safety guidelines. These guidelines constantly evolve, and pediatricians should not assume any guardian is up to date on the most recent recommendations. Good guidance is the cornerstone of pediatric care,” she said.

Dr. Richard Wasserman, from the University of Vermont College of Medicine in Burlington, commented on this study for Reuters Health.

“It’s a modest study, but with an important lesson,” he said.

“Speaking both as a grandparent and a pediatrician, it is not surprising that grandparent caregivers would be unaware of the latest recommendations on safety, diet, or anything else. Pediatric recommendations change. I recall in the early 1990s telling parents of newborns to have them sleep ‘on their stomachs’ one week, and then flipping my advice to ‘sleep on their backs’ the next.”

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