Parents make multiple decisions on a daily basis, and clinicians may not fully understand the reasons behind specific decisions. We describe some theoretical frameworks that may help explain how parents make decisions about infant sleep practices. The socio-ecological model suggests that parents’ infant sleep practices influence, and are influenced by, factors at the infant, maternal, family, household, neighborhood, and society levels. The integrated behavioral model presents several constructs, including attitudes, perceived norms, personal agency, knowledge and skills, salience of the behavior, environmental constraints, and habit that impact a parent’s intended and actual infant sleep practices. We present a decision-making path that parents may use when weighing all of the sources of information about infant sleep. Finally, we provide suggestions for how clinicians may use this information to influence parental decision-making about infant sleep practices.