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Grandparent Caregiver Knowledge of Anticipatory Guidance Topics

Sunday, October 21, 2012: 4:30 PM
Grand Salon D21/D24 (Hilton Riverside)
Amanda D. Soong, MD1, Kathryn C. Hines, MD1, H. Hughes Evans, MD, PhD1 and James Jackson, PhD2, (1)Pediatrics, UAB, Birmingham, AL, (2)Medical Education, UAB, Birmingham, AL


According to recent studies and census results, the number of grandparent caregivers has been increasing since the 1990s. The number of grandparent caregivers has increased 10% in the last decade alone. As the number of grandparent and older adult caregivers increase, pediatricians need to pay special attention to the anticipatory guidance they provide to these families. While the caregivers may be experienced in caring for young children, there may have been many changes in safety and anticipatory care recommendations since they last parented. The purpose of this study was to survey local Grandparent and Kinship Care support group members’ knowledge of basic young children safety recommendations. Using the results, pediatricians can tailor their anticipatory guidance recommendations to address knowledge deficiencies identified in the survey.


After obtaining approval from UAB’s Institutional Review Board and 3 local Grandparent/Kinship Care support groups, we attended regularly scheduled support groups. After providing details of our study, the participants completed a 15 question survey which addressed common pediatric safety and anticipatory guidance topics for children of all ages. The topics on the survey were selected from a list of common topics covered at routine well child checks. Once the surveys had been completed and collected, the answers were discussed with the group. The surveys were then analyzed.


49 surveys were collected from 3 different support groups in the Birmingham, AL metro area. A summary of the most significant results follow:  When asked, “what is the best position for a baby to sleep in?”, 33% of respondents chose on the stomach, 23% chose on the side, and 43.8% chose on its back. When asked at what age a baby should start drinking water, 42.9% answered 2 weeks of age, 20.4% answered 2 months, and 36.7% answered either 4 or 6 months.  When asked about correct car seat positioning, 24.5% responded that a 22 pound 9 month old should be facing forward. 49% of respondents believed that infant beds should contain bumpers, stuffed animals, and blankets in addition to mattresses and sheets, while only 26.5% would only have a mattress with a sheet in the crib. Finally, 73.9% of respondents believed that a walker is a good device to help babies learn to walk.


Safety and anticipatory guidance advice may change significantly over time. Our survey results demonstrate significant gaps in knowledge of important safety topics in grandparent and older adult caregivers. Pediatricians need to be aware of older family members who have child care responsibility, and should pay special attention when speaking to grandparent caregivers about topics such as sleep and crib safety and infant care, as many recommendations may have changed since the grandparents first parented.