Transcript Karen Passey - SIDS / Child Safety

What we have achieved in Victoria…
• Emergency response
• Policy
• Increase number of presentations and reach average of 3000
health professionals per year
• Childcare educators
• Child protection
• Family Services
• Maternity Services
• Foster carers
• Indigenous health workers and CALD groups
• Pharmacists/retail
• Representation re nursery products ACCC/Consumer Affairs
• Maternal Child Health Nurses
Provide a safe sleeping environment night
and day
Majority of SUDI occurring in Victoria
had at least one modifiable risk factor
Parents and health professionals are either
unaware, do not understand, or choose to
ignore the Safe Sleeping recommendations
Sharing a Sleep Surface
The Victorian coroner recently made
recommendations based on his findings following
investigation of the cases of four Victorian babies
who died in 2009 and 2010 who shared a sleep
surface with another person usually an adult care
giver.
The Coroners Prevention Unit examined a total of 72
infant deaths occurring in a sleeping context over a
three year period. It found that 33 of these deaths
occurred whilst the infant was sharing a sleep
surface with another person (Bugeja et al. 2011).
A statistically significant association was identified
for infants less than four months and the presence of
a pillow with deaths occurring in a co-sleeping
context.
• The coroner recommended on current evidence that
the safest place for an infant to sleep is on their back
on a separate sleep surface in a safe cot in the same
room as a caregiver for the first six to 12 months of
life.
• The coroner further recommended that consistent
and evidence-based messages be given to parents
about safe sleep practices for infants by health
professionals, and that policy be in alignment with
the SIDS and Kids information statement ‘Sleeping
with a baby’
Resources?
Where to from here…
•Consistent, clear, evidence-based messages to be given
•Policy to be implemented and on going education
•Create stronger and supportive
environments for all professionals
•Government support to sustain our
work and growth
•Victorian infants slept in safe sleeping
environments
Definitions
CO-SLEEPING=Being asleep on the same sleep surface as
the baby (UNICEF)
BEDSHARING=Bringing baby onto a sleep surface when cosleeping is possible, whether intended or not (UNICEF)
Roomsharing
Sharing the same sleep surface
Why is room sharing protective against sudden
and unexpected infant death?
• facilitates a rapid response to a baby’s needs, more
convenient settling ,comforting of babies, and closer motherbaby contact and communication
•increased adult supervision and observation of the baby
•Studies of nighttime mother-baby interactions have demonstrated
that compared to mothers who sleep apart from their babies, babies
and mothers who sleep in close proximity demonstrate increased
physical contact, more breastfeeding episodes and increased arousals
Benefits of Bed sharing/Roomsharing
(Blair 2010)
Physiological benefits
• mother/infant contact=>increases infants skin temp, stabilises
heart temp, reduces crying, increases milk production
Psychological and Emotional benefits
• Increased self esteem later in life
• Less psychiatric problems
• Improved cognitive performance
• Impact on breastfeeding probably biggest concern if
discouraging bed sharing
“…may conceivably reduce SIDS(SUDI) rates even further but not
necessarily infant mortality in general.”
Bed-sharing
Is there a significant risk?
ANSWER
• More SIDS infants are found in the parental bed
than expected
• Additional increase in number of co-sleeping
deaths on sofas and chairs
• Proportion of bed sharing deaths within SUDI
appears to have risen dramatically although actual
number of SIDS has decreased
Co-sleeping
Do we understand the nature of the risk?
ANSWER;
Some researchers state
• Not bed sharing that is dangerous, but instead the
particular circumstances in which bed sharing
occurs that is dangerous
• Infant care practices that parents who bed share
exhibit:
An Unsupervised Adult Bed May Be Unsafe
For Babies Or Toddlers
Risks increased if co sleeping with
other children or unrelated carers
or pets
What are the risks?
•Co-sleeping on sofas,
•Risks increased when co-sleeping with an adult is a smoker
•Covering of infants face and head Use of doonas, loose
bedding, pillows, sheepskin underlays
•CO2 rebreathing
•Thermal stress