Human Development & Family Studies


McIvor Mason, Irene

Advisor Department

Human Development and Family Studies




cardiac patient; infant development; reflux; safe sleep

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 License.


The rate at which an infant develops both physically and cognitively is significant during sleep, as this is the time when the entire body can dedicate its efforts to this cause. Parents of healthy infants follow the guidelines set by the American Academy of Pediatrics (AAP) relating to safe sleep, and since their introduction in 1992, the rate of Sudden Infant Death Syndrome (SIDS) has decreased by 40% (Center for Disease Control and Prevention, 2016). However, if an infant has been hospitalized since birth due to necessary invasive procedures such as open-heart surgery, these protocols cannot be initially implemented. Common complications among post cardiac surgery infants include inability to regulate temperature (requiring coverings for comfort and safety), and reflux initiating some elevation to relieve this pain. However, a review of the literature indicates that in most cases, as the infant recovers, these conventions related to sleep can be tapered off and safe sleep guidelines instituted. Staff will often teach the value of following safe sleep guidelines to new parents, even though the practices their child has followed while hospitalized differ from the guidelines. However, when these babies are discharged home, parents are reporting that their children are having a great amount of difficulty falling and staying asleep despite the fact that they are following the protocol.

This project expanded upon a 2018 patient quality care improvement study being conducted in the Cardiac Step-Down Unit at Boston Children’s Hospital. The purpose of this project was to utilize a survey created to gather information that identifies major factors related to why safe sleep protocol is not being instituted earlier. Further analysis and review of the literature was conducted to project the validity of these preventative factors. At Boston Children’s Hospital, the information collected from the survey is being used to develop an educational module for staff nurses, teaching them how to better implement AAP safe sleep guidelines into their care of infant cardiac patients. The long-term goal of this project is to improve family satisfaction of infant sleep quality post-discharge. Furthermore, children who have undergone any type of cardiac intervention have heightened developmental needs that can be affected long-term by a number of factors during a hospital stay. Mitigating these factors and better serving these patients’ cognitive needs during the first days of post-op is the first step to improving positive health outcomes as they continue to age.