Despite a 23-year campaign urging that babies be put to bed on their backs, only 43.7% of US mothers report that they both intend to use this method and actually do so all the time, according to a new study.

The Safe to Sleep campaign has been telling both caregivers and parents to use this position since 1994. Placing babies on their backs before they go to sleep reduces the risk of sudden infant death syndrome, an unexplained fatal condition also known as SIDS, as well as other sleep-related infant deaths like suffocation, according to the US Centers for Disease Control and Prevention.