Statement of purpose An average of 41 infants died each year during 2004–2010 in Massachusetts due to sudden unexplained infant death (SUID). Safe sleep practices can reduce SUID risk. Approximately 40% of new mothers in Massachusetts are enrolled in the Women, Infants, and Children (WIC) program. WIC provides a platform for deploying information on safe sleep practices. The purpose of our study is to evaluate a train-the trainer program among WIC counsellors to promote safe-sleep practices among post-partum WIC enrolled mothers.

Methods/Approach A statewide train-the trainer program was conducted among WIC area office supervisors, who subsequently trained their staff on the revised (2011) American Academy of Paediatrics safe sleep recommendations. Pre-posttest assessments measured program impacts (knowledge, attitudes, behaviours) 6-months post intervention. Herein we report on WIC counsellors’ safe sleep client counselling behaviours. Counsellors were asked how many of their clients they had counselled in the last month about: (1) safe sleep positioning; (2) safe crib contents; and (3) risks of co-sleeping. Response categories were: None; Some; Half; Most; and All.

Results Six month posttests were completed by 68% of WIC staff. Of staff whose jobs involved client counselling, 278 received training. Pre-posttest changes in proportions of trained counsellors who reported counselling" most or all" of their clients were: 11% (pretest) to 38% (posttest) for safe sleep positioning; 8% (pretest) to 28% (posttest) for safe crib contents; and, 9.7% to 32% for risks of co-sleeping.

Conclusions WIC counsellors were more apt to promote safe sleep practices after receiving the intervention. Around 40% of new mothers in Massachusetts are enrolled in WIC. Thus, training WIC counsellors could be an efficient and effective method for promoting safe sleep practices.

Significance and contribution to the field Safe sleep practices can reduce risk of SUID among WIC participants. The WIC program provides a unique venue to share information on best infant sleep practices. This program could serve as a national model for promoting safe-sleep.