A distressing new study finds that less than half (44%) of mothers intend to and consistently follow sleep guidelines that recommend infants be put to sleep on their backs.

The American Academy of Pediatrics recommends parents place newborns and infants on their backs to sleep to reduce the risk of sudden infant death syndrome. The study, co-authored by Eve Colson, professor of pediatrics at Yale School of Medicine in New Haven, Connecticut, found 77% said they usually put their babies to sleep on their backs—but not always. The study, published in the September issue of the journal Pediatrics, found that parents who heard the advice from their baby’s doctor were more likely to follow it.