36-week preterm baby has mild desaturation during deep sleep but no serious complications. Which of the follo… - AIIMS M.Sc. Nsg Entrance exam-2026

AIIMS M.Sc. Nsg Entrance exam-2026

Child Health Nursing (Pediatrics)

Medium

Appeared in: AIIMS M.Sc. Nsg Entrance exam-2026

Explanation

The supine (on the back) position is the universally recommended safe sleep position for all infants to significantly reduce the risk of Sudden Infant Death Syndrome (SIDS).
This recommendation applies to both full-term and medically stable preterm infants.
For a stable infant with only mild desaturation, the risk of SIDS from prone or side sleeping far outweighs any potential minor respiratory benefit.
Evidence confirms that the supine position does not increase the risk of choking or aspiration, even in infants with reflux, as their airway anatomy naturally protects against it.

Option A: The prone (stomach) position is the most significant modifiable risk factor for SIDS.
Option B: This option is dangerously vague and provides no specific, safe guidance. Infant sleep recommendations must be precise and evidence-based to prevent harm.
Option D: Bed-sharing (co-sleeping) is a major risk factor for SIDS, as well as accidental suffocation, entrapment, and overlay (an adult rolling onto the infant).

Visual 1: Infographic: The ABCs of Safe Sleep, visually representing an infant Alone, on their Back, in a clear Crib.
Visual 2: Diagram: A side-by-side comparison of a safe sleep environment (firm mattress, fitted sheet only) versus an unsafe environment (soft mattress, loose blankets, pillows, bumper pads, and toys).

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Safe sleep practices for infants and Sudden Infant Death Syndrome (SIDS) prevention as background academic context rather than a clinical decision trigger.
Nurses play a crucial role in educating parents on safe sleep practices before hospital discharge. This education is a key public health intervention to prevent infant mortality.
Parental education must address and correct common misconceptions, such as the fear of the infant choking while on their back.
What if? If the preterm infant had severe respiratory distress syndrome (RDS) and was on a ventilator in the NICU, the clinical team might decide to use the prone position to improve lung mechanics and oxygenation. In this critical care setting, the immediate need for respiratory support under constant monitoring would temporarily take precedence over SIDS prevention guidelines.

How to Approach the Question

First, identify the patient population and the core of the question: finding the safest sleeping position for a late preterm infant.
Recall the single most important safety guideline related to infant sleep: the 'Safe to Sleep' campaign to prevent SIDS.
The primary recommendation from this campaign is placing the infant on their back (supine) for all sleep.
Next, evaluate the clinical detail provided: 'mild desaturation'. Ask yourself if this finding is severe enough to override a major, life-saving safety protocol. In this case, 'mild' and 'no serious complications' indicate it is not.
Analyze the options based on the primary safety rule. Eliminate options that directly contradict it (prone position, co-sleeping) or are dangerously non-specific ('any position').
Select the option that aligns with the universal, evidence-based guideline for SIDS prevention.

Concept Tested & Keywords

Concept Tested: Safe sleep practices for infants and Sudden Infant Death Syndrome (SIDS) prevention.
Stem keywords: 36-week preterm, mild desaturation, deep sleep, sleeping position
Lead-in keywords: most appropriate
Clinical cues: 36-week preterm: This is a known risk factor for SIDS, making adherence to safe sleep guidelines even more critical.
Clinical cues: Mild desaturation: This detail tests the nurse's ability to prioritize the significant risk of SIDS over a minor, transient clinical finding in a stable infant.

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