Reducing the Risk of SIDS in Child Care

Presented by:

Massachusetts Department of Early Education and Care

Developed in Collaboration with:

Associated Early Education and Care

Child Development and Education, Inc.MA SIDS Center

MA Department of Public Health

REDUCING THE RISK OF REDUCING THE RISK OF SIDS IN CHILD CARESIDS IN CHILD CARE

Revised February, 2012

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Reduce the risk of infants dying

of SIDS in child care settings.

INTENDED OUTCOME OF THIS TRAINING

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Define SIDS Address misconceptions about SIDS deaths Discuss Risk Factors associated with SIDS Design a Safe Sleep Policy Discuss and provide safe sleep information to parents Follow appropriate procedures should an infant death occur in the

program Identify and access SIDS-related resources

LEARNING LEARNING OBJECTIVESOBJECTIVES

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The sudden death of an infant under one year of age when the cause of death remains unexplained after:

• Death scene investigation and autopsy

• Review of baby’s medical history

WHAT IS SUDDEN INFANT WHAT IS SUDDEN INFANT DEATH SYNDROME?DEATH SYNDROME?

• 4500 infants die of no obvious cause in the U.S. annually• Of these, 50% are due to SIDS• SIDS is the leading cause of death for infants between 1 and 12 months of age• SIDS rates have declined by more than 53% since 1990• Deaths in child care* in US accounted for 20% in 1996 and 16.5% in 2001

(Moon, et.al., Pediatrics, 2000 and 2005)• The exact cause of SIDS remains unknown• Experts cannot predict which babies will die from SIDS

* child cared for by a non-parental caregiver.

SIDS FACTSSIDS FACTS

Massachusetts SIDS Center5

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SIDS RISK FACTORSSIDS RISK FACTORS

• Babies who sleep prone (lying face downward)

• Babies who sleep on their sides• Unaccustomed tummy sleepers• Smoking during pregnancy • Exposure to 2nd hand smoke• American Indian and African

American babies• Multiple Births• Males slightly more than

females• Young Maternal Age (under 20)

• Mothers with late or no prenatal care

• Preterm (before 37 weeks) and birth weight under 5.5 lbs.

• Bed sharing• Mild upper respiratory

infections• Soft sleep surfaces• Cluttered sleep area• Overheating: temperature range

should be 68°-72°• Substance abuse during

pregnancy

Massachusetts SIDS Center

What is Bed Sharing?

Bed Sharing refers to a sleeping environment in which the baby shares the same sleeping surface with another person.

What is Co-Sleeping?

Co-Sleeping refers to a sleeping environment in which the baby shares the same room with a parent/caregiver.

BED SHARINGBED SHARING

Infants who share a bed with another person, adult or child, are at an increased risk for SIDS.

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SIDS

Critical development period

External stressors (Sleep position and sleep environment)

Vulnerable infant

TRIPLE RISK MODELTRIPLE RISK MODEL

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• Two thirds of US infants younger than 1 year are in non-parental child care.

• Infants of employed mothers spend an average of 22 hours per week in child care.

• Statistically, we would expect less than 9% of SIDS deaths to occur in child care.

Ehrle et al, 2001

Infants in Child Care

Massachusetts SIDS Center

SIDS AND CHILD SIDS AND CHILD CARECARE

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SIDS IN CHILD CARESIDS IN CHILD CARE

Although we would expect less than 9% of SIDS deaths to occur in child care settings;

• In the United States, 16.5% of SIDS deaths occurred while the infant was in the care of a non-parental caregiver.– 36.7% in family child care– 17.7% in child care centers– 21.3% in relative care– 17.7% with nanny/babysitter at home

» Moon & al. 2005

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Number of SIDS Deaths in Massachusetts1990 - 2001

0

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30

40

50

60

70

80

90

100

90 91 92 93 94 95 96 97 98 99 '00 '01

Totalnumber ofSIDSDeathsSIDSDeaths inchild care

Chart: Massachusetts SIDS Center

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• Place baby on back to sleep• Use firm surface• Keep soft objects and loose

bedding out of sleep area/crib• Avoid overheating• Supervise infants during sleep• Place one infant at a time in

each crib / playpen / bassinet for sleep.

• Do not smoke around infants• Consider a pacifier at nap

and bedtime during 1st year (with parental approval)

• Continue to educate others about SIDS and safe sleep practices

Massachusetts SIDS Center

REDUCING THE RISK OF REDUCING THE RISK OF SIDSSIDS

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1. Back to Sleep

2. Avoid Overheating

3. Safe sleep environment and supervision

4. “Tummy Time” when infant is awake and supervised

SIDS RISK REDUCTIONSIDS RISK REDUCTION

SIDS RISK REDUCTION:SIDS RISK REDUCTION:

BACK TO SLEEP

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Why don’t people put babies to sleep on their backs?

EXAMINING COMMON BELIEFSEXAMINING COMMON BELIEFS

• The baby may spit up / choke

• The baby will get a bald spot

• The baby will get a flat head

Before After

• The baby won’t sleep as soundly

– Check baby upon arrival at program. If baby is in car seat, remove and place in crib

– Never cover baby’s head with a blanket

– Room temperature should be between 68°-72°

– Do not overdress baby or leave in winter clothes while inside or during extended rides in a car seat

SIDS RISK REDUCTION SIDS RISK REDUCTION

AVOID OVERHEATINGAVOID OVERHEATING

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SIDS RISK REDUCTION SIDS RISK REDUCTION

A SAFE SLEEP ENVIRONMENT AND A SAFE SLEEP ENVIRONMENT AND SUPERVISIONSUPERVISION

• Safe crib• No blankets• No pillows• No toys• No wedges• No smoke

Safe sleep environment while Safe sleep environment while transporting? transporting?

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SIDS RISK REDUCTION SIDS RISK REDUCTION TUMMY TIMETUMMY TIME

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SIDS RISK REDUCTIONSIDS RISK REDUCTIONCommunicate with ParentsCommunicate with Parents

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• Have a plan in place

• Review the plan with all staff periodically

• Practice emergency response

• Be trained in infant first aid and CPR

HANDLING A MEDICAL HANDLING A MEDICAL EMERGENCYEMERGENCY

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• Initiate one sequence of CPR• Call 911• Return to CPR• Call emergency child care backup person• Send/bring infant’s medical records to hospital• Accompany infant to hospital, if possible• Notify parents• Notify supervisor if you have one or child care system• Notify EEC

FIRST AID: FIRST AID: UNRESPONSIVE INFANTUNRESPONSIVE INFANT

This presentation was adapted from Reducing the Risk of SIDS

Designed by:The American Academy of Pediatrics:

2004, revision 4/05

with assistance from:Mary McClain, RN, MS

Massachusetts SIDS Center

Revised 2/12

THANK YOU

Supplemental Handouts:•Questionnaire•Additional Resources•Certificate of Completion

Right click on the link below, then choose “open hyperlink” to access important documents.