Transcript REDUCING THE RISK OF SIDS

REDUCING THE RISK OF
SIDS IN CHILD CARE
Based upon the research of and
information provided by
Revised – 06/12
Healthy Child Care America
Back to Sleep Campaign
• Launched in 2003
• Activities
– Increase awareness
– Decrease incidence of SIDS in child
care
– Educate policy makers to include Backto-Sleep positioning in child care
regulations.
Revised – 12/08
• Numerous sources were used for developing this course
revision.
• An important source was the 2012 “Safe Sleep Practices and
SIDS / Suffocation Risk Reduction”. This report should be
in all licensed childcare centers. It is a joint collaboration
between: AAP (American Academy of Pediatrics), APHA
(American Public Health Association), National Resource
Center for Health and Safety in Child Care and Early
Education. Additional information was provided by the
Maternal and Child Health Bureau, the Health Resources and
Services Administration and the U.S. Department of Health
and Human Services.
Revised – 12/08
What is Sudden Infant Death
Syndrome (SIDS)?
From the U.S. Department of Health and Human Services and the Eunice Kennedy
Shriver National Institute of Child Health and Human Development
Definition: “The sudden death of an
apparently healthy infant, usually between
two weeks and one year of age, which usually
occurs during sleep. It is unexpected from
the medical history and remains unexplained
after a thorough autopsy and study of the
circumstances of death.”
Revised – 12/08
SIDS Facts
• More boys (60%) die of SIDS than
girls.
• Death is sudden and unpredictable.
• It appears to be painless and occurs
most often during sleep. There are
some cases of infants dying while
awake.
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SIDS Fact
• In most cases the baby appears healthy.
• Some infants will have signs of a cold just
before death but this is not a precursor of
SIDS. There appears to be a seasonal
affect: more babies die in winter, fall and
spring.
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SIDS Facts
• The major cause of death in infants between two
weeks and one year of age.
• The baby is not a victim of a rare disease. In the
U.S., nearly 2,500 babies die each year from SIDS
(NICHD 2010). This is about one death every 3 hours.
• SIDS deaths have decreased by nearly half from
1990 to 2010 due to public awareness.
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SIDS Facts
• Occurs in families of all social and economic
backgrounds.
• Is as least as old as the Old Testament and seems to
have been as frequent in the 18th and 19th centuries as
it is now.
• Researchers believe that SIDS probably has multiple
causes with the final process of death resulting in
respiratory failure
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What Does the Evidence
Show
Many SIDS infants are born with brain abnormalities
that cause a vulnerability to SIDS.
They are found in the “arcuate nuclei” which control
the major bodily functions:
heart rate
respiration
temperature
the ability to awaken.
This is merely a suggestion at this time.
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What SIDS Is Not
It is not caused by immunizations.
It is not caused by vomiting or
choking.
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SIDS in Child Care
• Approximately one third of
SIDS-related deaths in child
care occur in the first week
• Half these occur on the first
day!
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Development Matters
By 6 months
• Head and neck control aid baby
when she rolls over autonomously
during sleep.
• Body temperature controls located
in the brain are well developed.
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Reducing the Risk of SIDS
After 50 years of research,
there is no definitive cause of
SIDS. There is no way to
predict it, but there are ways
to help reduce the risk of its
occurrence.
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Back-To-Sleep Campaign
• an educational campaign that recommends
caregivers always place infants under the age of 1
year on their backs to go to sleep.
• The infants may roll over on their own and selfdetermine how they end up sleeping.
• This sleeping position has brought about a
significant reduction in SIDS deaths.
Revised – 12/08
More Ways to Reduce the
Risk
• Caregivers are required to place
babies under 1 year of age on their
backs to sleep
• If there is a health reason for not
placing the child on its back to sleep,
the child’s physician must provide
written orders to the child care
center!
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Reducing the Risk
• Babies are to sleep ONLY in cribs!
• Babies may not be put to sleep on their
side.
• Infants may not be propped with
wedges or any other item
• This information is shared with
parents.
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Safe Places to Sleep
The safest place for a baby to
sleep is in a separate sleep surface
(bassinet, crib, cradle) in a supine
position.
Unsafe sleep surfaces include car
seats, swings, bouncy seats.
Revised – 12/08
Caring for Our Children: National Health
and Safety Performance Standards—2002
Standard 3.008: Scheduled Rest Periods and Sleep
Arrangements
• Supine (back) sleep position for babies
• Physician’s note if position other than back
(that includes medical reason)
• Babies placed on back, but when able to turn
over, “allowed to adopt whatever position
they prefer to sleep”
• Positioning devices not to be used,
unless specified by a physician
Revised – 12/08
Reducing the Risk
• Blankets are never used to cover a baby’s
face to block sun, weather or noise. This
can cause an accumulation of exhaled air
which does not contain enough oxygen which
may lead to either SIDS or suffocation.
• If a blanket is used in a crib, either the
“feet to foot” rule” is followed or sleep
clothing is used. The face is never covered.
Revised – 12/08
Reducing the Risk
• A firm mattress is used in a crib that meets
the safety standards of Consumer
Protection Safety Commission.
• The crib must have been manufactured
after June 2011.
• The mattress should fit snugly in the crib
and the sheet must be a fitted sheet.
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Reducing the Risk
• Keep cribs free of all blankets, comforters,
pillows and stuffed animals.
• Bumper pads, heavy comforters and pillows
are never used.
• Within the next year, Colorado licensing
requirements will prohibit the use of
blankets in cribs!
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When Babies Arrive
at a PCA Location
If an infant arrives at the facility asleep in a
car safety seat, the parent/guardian or
caregiver will immediately remove the sleeping
infant from this seat and place them in the
supine position in the infant’s assigned crib.
Revised – 12/08
When Babies
Sleep at a PCA
School
Infants cannot and may not nap or sleep in a
car safety seat, bouncy seat, swing, jumping
chair, play pen or highchair while in our care.
If an infant falls asleep in any place that is not
a safe sleep environment, the staff will
immediately move the infant and place them in
the supine position in their crib.
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The Role of the Infant
Nursery Staff While
Babies Sleep
• Will visually check sleeping infants
every 15-20 minutes.
Sleep information will be
accurately recorded on Daily Note.
• Will be especially alert to monitoring a sleeping infant
during the first weeks the infant is in child care.
• Will check to see if the infant’s skin color is normal, watch
the rise and fall of the chest to observe breathing and look
to see if the infant is sleeping soundly. The infant will be
checked for signs of overheating including flushed skin
color, body temperature by touch and restlessness.
• Will ensure the sleeping area is properly illuminated.
“Infants do not require a dark and quiet place for sleep. Once they
become accustomed, infants are able to easily sleep without problems in
environments with light and noise.” Caring for Our Children
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Reducing the Risk
• Avoid overdressing or overheating the
baby.
• Hyperthermia may be one cause of SIDS.
The part of the brain that helps control
the body’s temperature also controls
breathing.
• Babies sleep well in a cool environment
(68°F)
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Reducing the Risk
• Keep the environment smokefree!
• Infants should never be exposed
to smoke. Second-hand smoke is
dangerous too.
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Reducing the Risk
• Maintain air circulation in the
sleeping environment
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Safe & Comfortable Sleeping
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Safe Sleep Policy According to
American Academy of Pediatrics
• The temperature in the room is comfortable
for a lightly clothed adult.
• The baby is placed in a supine position in the
crib. Blanket use is discouraged.
• Sleeping babies are monitored. Enough light
is available to view a baby’s breathing and
coloring.!
• All staff, substitutes and volunteers are
informed about / trained in Safe Sleep Policy
and practices
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Many PCA
schools
have a
Safe Sleep
Policy
which
parents and
staff sign
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When Babies Are Awake
Supervised Tummy Time when babies
are awake is required because it:
– Promotes healthy physical and brain
development
– Strengthens neck, arm, and shoulder
muscles
– Decreases risk of head flattening and
balding
– Encourages bonding and play between
the supervising adult and the baby
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Tummy Time
• Must occur 2 to 3 times a day.
• The amount of tummy time per day
should be increased as the baby gets
stronger.
•
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Caregivers should
document this time on the
baby’s Daily Report.
First Aid—Unresponsive Infant
• Teaching resuscitation skills is beyond the scope
of this workshop. You must first practice
resuscitation on a mannequin.
• Call 911.
• Get help to care for the other children.
• Call the child’s parents or emergency contact.
• Call the parents of the other children.
• Do not disturb the scene (e.g., don’t try to tidy
up).
• Notify licensing agency and insurance agency.
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What to Expect if a Baby Dies
• Investigation
– Several people will ask for the same
information so they can help
• Law enforcement
– Note baby’s health, behavior, etc.
– Take photos.
– Limit disturbance of the area
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What to Expect if a Baby Dies
• Licensing agency
– Questions about licensing regulations.
– SIDS death not a reason for revoking a
license.
• Coroner/medical examiner
– Conducts autopsy.
– Determines cause of death.
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Caring for Our Children
National Standards
• Seek support and information from local, state,
or national SIDS organizations.
• Provide SIDS information to the parents
of the children in the facility.
• Provide age-appropriate information to the other
children in the facility.
• Make resources for support available
to families and children.
Revised – 12/08
Healthy Child Care America
Back to Sleep Campaign
• American Academy of Pediatrics
141 Northwest Point Blvd
Elk Grove Village, IL 60007-1098
– Phone: 888/227-5409
– Fax: 847/228-7320
– E-mail: [email protected]
– Web site: www.healthychildcare.org
Revised – 12/08
Partners and Resources
• Back to Sleep campaign
– www.nichd.nih.gov/sids
– Phone: 1-800-505-CRIB (2742)
– You can receive informational
brochures, posters to provide to
families and child care providers
Revised – 12/08
Partners and Resources
• First Candle/SIDS Alliance
– 1314 Bedford Ave, Suite 210, Baltimore, MD 21208
– Phone: 800/221-7437 or 410/653-8226
– Fax: 410/653-8709
– E-mail: [email protected]
– Web site: www.firstcandle.org
• National SIDS and Infant Death Program Support Center
– 112 E Allegan, Suite 500, Lansing, MI 48933
– Phone: 800/930-SIDS or 800/930-7437
– E-mail: [email protected]
– Web site: www.sidsprojectimpact.com
Revised – 12/08
Licensing Requirements
• National Resource Center for Health and
Safety in Child Care and Early Education (NRC)
– www.nrckids.org
– 800/598-KIDS (5437)
– Caring for Our Children: National Health
and Safety Performance Standards:
Guidelines for Out-of-Home Child Care
Programs, Second Edition (2002)
– Colorado State Licensing information
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Practice Scenarios
• 4 scenarios that child care providers
may encounter in their workplace
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Scenario 1
A parent of a 2 month old baby
requests that the child sleep on the
side, propped by a pillow. This is how
they do it at home. The mother says, “I
don’t want to worry about my baby
spitting up and it going down the wrong
way.” What do you do?
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Scenario 2
A parent has requested that his baby be placed on
the stomach for naps. You showed him the policy that
babies are to be placed on the back only unless there
is a medical reason. He takes the medical waiver form
to the pediatrician. The pediatrician signs the waiver,
but does not indicate a medical reason. In fact, the
pediatrician has crossed through the section that
asks for a medical reason. What do you do?
Revised – 12/08
Scenario 3
You have just started as a new child
care provider in the infant nursery at
Gateway. On your first day, you notice
that all of the other providers are
placing babies on their stomachs for
naps. You know from your training that
back is best. What do you do?
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Scenario 4
There is a new baby in the infant room. She is
2 months old. The mother tried to get the
director to agree to put the baby on the
stomach for sleep, since that is what they do
at home. The director refused, and the
mother finally said that was okay. You now
place the baby on the back for a nap. The
baby cries and refuses to go to sleep. What
do you do?
Revised – 12/08