Sudden Infant Death Syndrome (SIDS) Resources for Childcare
Providers:
A Selected Annotated Bibliography
National Association for Regulatory Administration
(NARA)/ National Child Care Information and Technical Assistance
Center
The 2005 Child Care Licensing Study: Executive Summary. 2006.
The purpose of the 2005 Child Care Licensing
Study is to report two aspects of child care licensing from
2005 for all 50 states and the District of Columbia on state
child care licensing programs and policies and child care center
licensing regulations. Twenty- four states require that centers
place infants on their backs to sleep in order to reduce the
risk of Sudden Infant Death Syndrome. Twenty states allow physicians
to authorize a different sleep position; five states allow
parents to make this authorization. Seventeen states prohibit
soft bedding/ materials in cribs.
Available for full-text downloading: http://www.nara.affiniscape.com/displaycommon.cfm?an=1&subarticlenbr=99
Moon RY, Kotch L, Aird L.
State child care regulations regarding infant sleep
environment since the Healthy Child Care America-Back to
Sleep campaign.
Pediatrics. 2006 Jul; 118(1):73-83
Background: Despite overall decreases in
sudden infant death syndrome deaths and prone sleeping, the
proportion of sudden infant death syndrome deaths that occurs
in child care settings has remained constant at approximately
20%. In 2003, the American Academy of Pediatrics' Healthy Child
Care America program launched its own Back to Sleep campaign
to promote the Back to Sleep message for those who care for
young children. Objectives: The purpose of this study was to
evaluate the effectiveness of the first 2 years of the Healthy
Child Care America-Back to Sleep campaign in improving child
care regulations by assessing the inclusion of the elements
of a safe sleep environment in the individual state regulations
for child care centers and family child care homes. Methods:
We examined regulations available in October 2005 for licensed
child care centers and family child care homes in the 50 states
and the District of Columbia for specific regulations pertaining
to (1) sudden infant death syndrome risk-reduction training
for child care providers, (2) infant sleep position, (3) crib
safety, (4) bedding safety, (5) smoking, and (6) provision
of information about sleep positioning policies and arrangements
to parents before the infant is enrolled in child care. Results:
Since 2003, when the Healthy Child Care America-Back to Sleep
campaign began, 60 of the 101 state regulations for either
child care centers or FCCHs have been revised. More than half
of these regulations written since 2003 mandate a non prone
sleep position and restrictions on soft bedding in the crib,
and the change in these regulations since 2003 is statistically
significant. However, of the 101 existing state regulations,
only 49 require that infants sleep nonprone, 18 mandate sudden
infant death syndrome training for child care providers, 81
have > or = 1 crib safety standard, and 43 restrict soft bedding
in the crib. Only 4 regulations require that parents be provided
with sleep policy information. Conclusions: The initial 2 years
of the Healthy Child Care America Back to Sleep campaign have
been successful in promoting safe infant sleep regulations.
Efforts must continue so that safe sleep regulations exist
in all jurisdictions.
Full-text available at: http://www.pediatrics.org
American Academy of Pediatrics, Task Force
on Sudden Infant Death Syndrome.
The Changing Concept of Sudden Infant Death Syndrome:
Diagnostic Coding Shifts, Controversies Regarding the Sleeping
Environment, and New Variables to Consider in Reducing Risk
Pediatrics. 2005 Nov; 116(5):1245-55. E-pub 2005 Oct 10
There has been a major decrease in the incidence
of sudden infant death syndrome (SIDS) since the American Academy
of Pediatrics (AAP) released its recommendation in 1992 that
infants be placed down for sleep in a non prone position. Although
the SIDS rate continues to fall, some of the recent decrease
of the last several years may be a result of coding shifts
to other causes of unexpected infant deaths. Since the AAP
published its last statement on SIDS in 2000, several issues
have become relevant, including the significant risk of side
sleeping position; the AAP no longer recognizes side sleeping
as a reasonable alternative to fully supine sleeping. The AAP
also stresses the need to avoid redundant soft bedding and
soft objects in the infant's sleeping environment, the hazards
of adults sleeping with an infant in the same bed, the SIDS
risk reduction associated with having infants sleep in the
same room as adults and with using pacifiers at the time of
sleep, the importance of educating secondary caregivers and
neonatology practitioners on the importance of "back to sleep," and
strategies to reduce the incidence of positional plagiocephaly
associated with supine positioning. This statement reviews
the evidence associated with these and other SIDS-related issues
and proposes new recommendations for further reducing SIDS
risk.
Free full-text available at: http://aappolicy.aappublications.org/cgi/content/full/pediatrics;116/5/1245#SEC15
Moon RY, Sprague BM, Patel KM.
Stable prevalence but changing risk factors for sudden
infant death syndrome in child care settings in 2001.
Pediatrics. 2005 Oct; 116(4):972-7
Objective: A total of 20% of sudden infant
death syndrome (SIDS) cases in the 1990s occurred in child
care settings. This is much higher than the 8% expected from
Census Bureau data. Factors that were associated with child
care SIDS included older age; white race; older, more educated
mothers; and unaccustomed prone position. Since these findings,
much emphasis has been placed on promoting a safe sleep environment
in child care. The objectives of this study were to determine
the proportion of SIDS occurring in child care in 2001 and
to assess risk factors for SIDS in child care. Methods: We
conducted a retrospective review of all SIDS deaths that occurred
in 2001 in 13 US states. Information regarding demographics,
SIDS risk factors, and child care arrangements were collected
and analyzed. Deaths that occurred in child care were compared
with deaths that occurred during parental care. RESULTS: Of
480 deaths, 79 (16.5%) occurred in child care settings. Of
these child care deaths, 36.7% occurred in family child care
homes, 17.7% occurred in child care centers, 21.3% occurred
in relative care, and 17.7% occurred with a nanny/babysitter
at home. Infants in child care were more likely to be older
and to die between the hours of 8 am and 4 pm and less likely
to be exposed to secondhand smoke. There was no difference
in usual, found, or placed sleep position between child care
and home deaths. Approximately one half of the infants who
died of SIDS in both settings were found prone, and 20% of
deaths in both settings were among infants who were unaccustomed
to prone sleep. Conclusions: The proportion of SIDS deaths
in child care has declined slightly but still remains high
at 16.5%. Infants in child care are no more likely to be placed
or found prone and no more likely to be on an unsafe sleep
surface. Educational efforts with child care providers have
been effective and should be expanded to unregulated child
care providers. In addition, there may be other, yet-unidentified
factors in child care that place infants in those settings
at higher risk for SIDS.
Free full-text downloading available at: http://pediatrics.aappublications.org/cgi/content/full/116/4/972
North Carolina Healthy Start Foundation/
Blue Cross Blue Shield of North Carolina/ CJ Foundation for
SIDS.
Baby’s Easy Safe Sleep Training
Kit (BESST kit).
2005. 20p.
The BESST kit is an educational flip chart
and guide that offers important tips about infant safe sleep
and ways to reduce the risks of SIDS. This tool is aimed primarily
assist parents, caregivers, childcare providers, healthcare
professionals and others in raising awareness about, and reducing
the incidence of SIDS. The kit includes tabletop flip chart
with 16 illustrations, training guide, presentation tips, prop
ideas, outreach tips and samples of safe sleep materials from
the North Carolina Healthy Start Foundation. The kit is also
available in Spanish.
Available from: http://www.nchealthystart.org/BESST/flip_chart_info.htm
Healthy Child Care America/American Academy
of Pediatrics
A Child Care Provider’s Guide
to Safe Sleep: Helping you to reduce the risk of SIDS.
Elk Grove Village, IL: Healthy Childcare America/American Academy
of Pediatrics, 2005. 2p.
The information sheet provides child care
providers with straightforward information about safe sleep
practices as well as information about Sudden infant death
syndrome (SIDS). It answers questions like: Who is at risk
for SIDS? What can child care providers do? What a safe sleep
policy should include? How can I reduce the risk of infants
in my care? Am I a child care provider? Includes SIDS resources
and organizations websites.
Available from:
Healthy Child Care America/AAP
Back to Sleep Campaign
141 Northwest Point Blvd
Elk Grove Village, IL 60007
(888) 227-5409 (Toll-free)
(847) 228-6432 (fax)
http://www.healthychildcare.org
Free full-text downloading available at: http://www.healthychildcare.org/pdf/SIDSchildcaresafesleep.pdf
Healthy Child Care America/American Academy
of Pediatrics
Tummy Time
Elk Grove Village, IL: Healthy Childcare America/American Academy
of Pediatrics, 2005.
The brochure summarizes the importance of
supervised tummy time. It presents answers to questions like:
What are the 2 most important things to remember about the
Back to Sleep Campaign; How much tummy time should an infant
have? What if the baby does not like being on her tummy? Does
sleeping on back cause the baby to have a flat head? How can
I exercise the baby while on his tummy? Lists 7 easy steps
to create a safe sleep environment at home, family child care
home or child care center. Includes listing of SIDS resources
as well as SIDS organizations websites.
Available from:
Healthy Child Care America/American Academy of Pediatrics
Back to Sleep Campaign
141 Northwest Point Blvd
Elk Grove Village, IL 60007
(888) 227-5409 (Toll-free)
(847) 228-6432 (fax)
http://www.healthychildcare.org
Free full-text downloading available at: http://www.healthychildcare.org/pdf/SIDStummytime.pdf
C J Foundation for SIDS
Face Up to Wake Up: SIDS Risk Reduction Resource
Kit
Hackensack, NJ: C J Foundation for SIDS, 2004.
This culturally appropriate kit is intended
to support the reduction of racial and ethnic disparities in
Sudden Infant Death Syndrome (SIDS) among American Indians.
The kit includes a manual designed not only to assist the educator
in both one-on-one and classroom instruction but also to enhance
the instructors' current level of understanding regarding SIDS.
To further assist instructors, two videos in both VHS and CD-ROM
format are also included. There is also a resource CD that
contains posters, brochures and other educational materials
ready to be printed. These resources can be used to educate
through display, distribution and individual instruction.
Available from:
CJ Foundation for SIDS
Don Imus-WFAN Pediatric Center
Hackensack University Medical Center
30 Prospect Avenue
Hackensack, NJ 07601
(888) 825-7437 (Toll-free)
(201) 996-5111
(201) 996-5326 (Fax)
http://www.cjsids.com
First Candle/SIDS Alliance
Como Superar La Muerte De Un Bebe [Sudden Infant Death Syndrome: Surviving the Death of a Baby].
Baltimore, MD: First Candle/ SIDS Alliance. 2004. 11 p.
This brochure serves as an aid to parents
who have lost a baby to Sudden Infant Death Syndrome (SIDS).
It covers topics like grieving process parents undergo, coping
with birthdays, anniversaries and holidays, trying for another
baby, children's reactions to death, how grandparents undergo
double grief, how childcare providers react to the grief. Furnishes
contact information to stop unsolicited reminders of the baby's
death. Presents suggestions to friends and relatives in a do's
and don'ts format to assist SIDS parent’s
grief. Includes two poems entitled "Last day" by Deborah R.
Gemmill and "The journey of living on" by Sharon A. Dunn.
Available from:
National SIDS/ID Program Support Center (NSIDPSC)
1314 Bedford Avenue, Suite 210
Baltimore, MD 21208
(410) 415-6628
(800) 221-7437 (Toll-free)
(410) 653-8709 (Fax)
kathleen.graham@firstcandle.org (E-mail)
http://firstcandle.org/health/health_human.html
McClain M, Arnold J, Longchamp E, Shaefer
J.
Bereavement counseling for sudden infant death syndrome
(SIDS) and infant mortality: Core competencies for the health
care professional.
Stony Brook, NY: Association of SIDS and Infant Mortality Programs
(ASIP), 2004. 39p.
This guide presents core competencies essential
for the health care professional to provide appropriate and
effective bereavement counseling and support for a family.
Part I focuses on understanding and using infant mortality
statistics. It lists various data sources like National Center
for Health Statistics (NCHS), Title V Information System (TVS),
Peristats by March of Dimes, State Health Facts Online by Henry
J. Kaiser Family Foundation, and Infant Mortality Knowledge
path developed by Georgetown University's National Center for
Education in Maternal and Child Health (NCEMCH). Lists leading
causes of Infant Mortality and current trends in Infant Mortality.
Part II includes risk reduction for SIDS and Infant Mortality.
Part III focuses on bereavement counseling for SIDS and Infant
Mortality. It lists steps while counseling the bereaved parents,
counseling children about death and grief, counseling grandparents,
and counseling day care providers and foster parents. Part
IV covers the impact of grief counseling on the health care
professional. Also includes references and suggested reading
list on infant mortality statistics, risk reduction education,
bereavement counseling support, helpful books for children,
list of ASIP publications and collaborating organizations.
Includes list of organizations dealing with grief and bereavement.
Available from:
The Association of SIDS and Infant Mortality Programs (ASIP)
National SIDS& Infant Death Project IMPACT
8280 Greensboro Drive, Ste 300
McLean, VA 22102
(800) 930-7437
(703) 902-1260
(703) 902-1320 (Fax)
info@sidsprojectimpact.com (E-mail)
http://www.sidsprojectimpact.com
Free full-text downloading available at: http://www.sidsprojectimpact.com/_assets/documents/pdf/BerCouns--CoreComp.pdf
National SIDS/ID Program Support Center (NSIDPSC),
Infant Mortality Risk Reduction Work Team
Sudden Infant Death Syndrome and the Child Care Provider.
Sample Drill: Emergency Procedures for an Unresponsive Infant.
Rockville, MD: Health Resources and Services Administration
(DHHS/PHS), Maternal and Child Health Bureau. 1 p. June 2004.
This information sheet outlines the emergency
procedures that childcare providers should follow if they find
an infant in their care unresponsive.
Available from:
National SIDS/ID Program Support Center (NSIDPSC)
1314 Bedford Avenue, Suite 210
Baltimore, MD 21208
(800) 221-7437 (Toll-free)
(410) 415-6628
(410) 653-8709 (Fax)
Kathleen.graham@firstcandle.org (E-mail)
http://firstcandle.org/health/health_human.html
Free full-text downloading available at: http://firstcandle.org/FC-PDF3/sids%20&%20child%20care%20provider.pdf
American Academy of Pediatrics (AAP), Task
Force on Infant Sleeping Position and SIDS.
Infant Sleep Position and SIDS: Questions and Answers
for Health Care Providers.
Bethesda, MD: National Institute of Child Health and Human
Development (NIH). November 2003. 12 p.
This brochure, a product of the national
'Back to Sleep' campaign in the United States, presents questions
and answers for health care providers on infant sleeping position
and sudden infant death syndrome (SIDS). The 'Back to Sleep'
campaign was initiated in June 1994 to alert new parents and
health professionals to sleeping position as a possible risk
factor for SIDS. The brochure answers the following questions:
What advice should health care providers give to parents on
ways to reduce the risk of SIDS? What sleep position is safest
for full-term babies in hospital nurseries? Is the side position
as effective at reducing the risk of SIDS as the back sleep
position? Will babies choke if they are placed on their backs;
does back sleeping cause infants to have flat heads? Why should
parents and caregivers avoid soft surfaces for their infants
to sleep on? Can a baby ever be placed on his or her stomach;
Are there any circumstances when a baby should be placed to
sleep on his or her stomach? How should preterm babies be placed
for sleep? What advice should a heath care provider give to
a parent or caregiver whose infant has difficulty sleeping
in the back position? How often should parents or caregivers
check on an infant during sleep to make sure the baby has not
rolled into the stomach position from the back position? At
what age can parents and caregivers stop placing their babies
on their backs to sleep? Should parents or caregivers use products
that are designed to keep babies on their backs or sides during
sleep? What advice should health care providers give to parents
of babies in childcare? Does bed sharing reduce the risk of
SIDS? Information on the campaign's history is included.
Available from:
National Institute of Child Health and Human Development (NICHD)
Back to Sleep Campaign
31 Center Drive, 31/2A32
Bethesda, MD 20892-2425
(800) 505-CRIB
(301) 496-7101 (Fax)
http://www.nichd.nih.gov
Free full-text downloading available at: http://www.nichd.nih.gov/publications/pubs/upload/BTS_QA_Healthproviders.pdf
American Academy of Pediatrics, First Candle/SIDS
Alliance
Reducing the Risk of SIDS in Child Care: Training
for Child Care Providers. Speaker’s Kit
Elk Grove, IL: American Academy of Pediatrics. 2003.
This speaker's kit provides 1-to 2 hour training
to enable healthcare professionals, public health educators,
child care providers to educate their community about safe
sleep practices while spreading the message about reducing
the risk of SIDS in child care to caregivers. Includes CD-ROM.
Two-hour Power Point presentation and speakers notes can be
downloaded for free from Healthy Childcare America http://www.healthychildcar.org.
Available from:
Healthy Child Care America/ American Academy of Pediatrics
141 Northwest Point Blvd.
Elk Grove Village, IL 60007-1098
(847) 434-4016
(847) 228-6432 (Fax)
hcca@aap.org (E-mail)
http://www.healthychildcare.org
Full-text downloading of both PowerPoint
presentation as well as PDF available at: http://www.healthychildcare.org/section_SIDS.cfm
American Academy of Pediatrics/Healthy Child
Care America
Curso de Capacitacion Orientado al Personal Dedicado
al Cuidado Infantil: Sindrome de Muerte Subita del Lactante.
Sindrome de Muerte Subita del Lactante: Como Disminuir su
Incidencia en Ambitos Dedicados al Cuidado Infantil [Reducing the Risk of SIDS in Child care: Training for Childcare providers]
El Grove Village, IL: American Academy of Pediatrics. 2004.
Spanish-language speaker’s
kit provides 1-to 2 hour training to enable healthcare professionals,
public health educators, child care providers to educate their
community about safe sleep practices while spreading the message
about reducing the risk of SIDS in child care to caregivers.
Includes CD-ROM. Two-hour Power Point presentation and speakers
notes.
Available from:
Healthy Child Care America/ American Academy of Pediatrics
141 Northwest Point Blvd.
Elk Grove Village, IL 60007-1098
(847) 434-4016
(847) 228-6432 (Fax)
hcca@aap.org (E-mail)
http://www.healthychildcare.org
Full-text downloading of both PowerPoint
presentation as well as PDF available at: http://www.healthychildcare.org/section_SIDS.cfm
Moon RY, Oden RP.
Back to Sleep: Can we Influence Child Care Providers?
Pediatrics 112(4): 878-882, October 2003.
Objective: Despite the fact that 20% of sudden
infant death syndrome (SIDS) deaths occur in child care settings,
many child care providers continue to be unaware of the association
of SIDS and infant sleep position and/or are misinformed as
to the risks and benefits of the various sleep positions. The
objective of this study was to determine whether an educational
program for child care providers regarding SIDS and safe sleep
environment is effective in 1) providing basic information
and understanding regarding SIDS risk reduction practices,
2) changing child care provider behavior, and 3) promoting
development of written sleep position policies. Methods: We
designed a 60-minute educational in-service for child care
providers, to be led by a trained health educator. All providers
who attended the in-service were asked to complete surveys
before and after the in-service. Surveys assessed provider
knowledge, beliefs, and practices. A 6-month follow-up interview
was conducted with childcare centers that had providers participating
in the in-service. Results: A total of 96 childcare providers
attended the educational in-service. Providers who were using
the supine position exclusively increased from 44.8% to 78.1%.
This change in behavior was sustained, with 85% of centers
placing infants exclusively supine 6 months after the intervention.
Awareness of the American Academy of Pediatrics recommendation
of supine as the preferred position for infants increased from
47.9% to 78.1%, and 67.7% of centers continued to recognize
supine as the recommended position 6 months later. The percentage
of centers that reported written sleep position policies increased
from 18.8% to 44.4%. Conclusions: A targeted educational in-service
for child care providers is effective in increasing awareness
and knowledge, changing child care provider behavior, and promoting
development of written sleep position policies. This change
is sustained over at least a 6-month period (18 references).
Free full-text downloading available at: http://pediatrics.aappublications.org/cgi/reprint/112/4/878
National SIDS/ ID Program Support Center
(NSIDPSC)
Training manual about Sudden Infant Death Syndrome
(SIDS) in Child Care Settings.
Baltimore, MD: National SIDS & Infant Death Program Support
Center. 2003.
The Training Manual provides up to date information
regarding SIDS research and best practices to reduce the risk
in childcare settings. Section I includes training guide which
provides tips on conducting the Train-the Trainer Workshop
and/or the child care provider workshop. Section II includes
presentation/training script, presentation script is intended
to assist trainers in conducting a workshop for child care
providers, provides guidelines, suggestions in conducting a
power point slide workshop. Training script includes trainer's
notes reminding trainer's important points and information
with each power point slide. Section III includes materials
about SIDS to the trainers. Section IV provides supplemental
information that could contribute to increase knowledge about
SIDS. Packet includes a CD-ROM.
Available from:
National SIDS/ID Program Support Center (NSIDPSC)
1314 Bedford Avenue, Suite 210
Baltimore, MD 21208
800-221-7437 (Toll-free)
410-415-6628
410-653-8709 (Fax)
kathleen.graham@firstcandle.org (E-mail)
http://firstcandle.org/health/health_support.html
American Academy of Pediatrics; American
Public Health Association; National Resource Center for Health
and Safety in Child Care.
Reducing the Risk of Sudden Infant Death Syndrome
(SIDS). Applicable Standards from Caring for Our Children.
Elk Grove, IL: American Academy of Pediatrics. 2002.
This booklet presents the standards for SIDS
prevention in childcare settings, providing critical information
for childcare providers, government policy makers, health care
consultants, and parents. It includes standards for caregiver
qualification and training, proper sleep position, bedding,
and reporting as well as related health policies. 12 references.
Available from:
American Academy of Pediatrics
141 Northwest Point Boulevard
Elk Grove Village, IL 60007-1098
(866) 843-2271 (publication orders)
(888) 227-1770 (outside the U.S. and Canada); (847) 228-1281
(847) 228-1281 (Fax)
hcca@aap.org (E-mail)
http://www.aap.org
Free full-text downloading available at:
http://nrc.uchsc.edu/SPINOFF/SIDS/SIDS.htm
Sanders DB Ed.
Helping Children Grieve: Sudden Infant Death Syndrome.
Rancho Cordova, CA: California SIDS Program. 2001. 8 p.
This booklet is directed at persons who care
for children who have lost a sibling to sudden infant death
syndrome (SIDS), including parents, grandparents, childcare
providers, clergy, teachers, and other friends and relatives.
When a baby dies suddenly with no warning, the whole family
must cope with confusing emotions. Surviving siblings need
a way to express their feelings, they need help and support,
and they need to feel loved and valued. The booklet discusses
the types of emotions that children may feel while grieving
for an infant sibling who has died, including fear, anger,
guilt, and sadness. The booklet also discusses when parents
or others should worry about a child's reactions to the death;
the importance of everyone talking about the death; what one
should and should not say about where the baby went; siblings'
participation in the funeral; ways in which siblings can remember
the brother or sister who died; and how the level of understanding
of death differs with a child's age.
Available from:
California SIDS Program
11344 Coloma Road, Suite 560
Gold River, CA 95670-6304
(916) 851-7437
(800) 369-7437 (in CA)
(916) 851-5937 (Fax)
info@californiasids.com (E-mail)
http://www.californiasids.com
Sanders DB Ed, Tarano E trans.
Ayudando a los ninos con su pena: Sindrome de muerte
infantil repentina [Helping Children Grieve: Sudden Infant Death Syndrome].
Rancho Cordova, CA: California SIDS Program. 1999. 13 p.
This booklet is directed at Spanish-speaking
persons who care for children who have lost a sibling to sudden
infant death syndrome (SIDS), including parents, grandparents,
childcare providers, clergy, teachers, and other friends and
relatives. When a baby dies suddenly with no warning, the whole
family must cope with confusing emotions. Surviving siblings
need a way to express their feelings, they need help and support,
and they need to feel loved and valued. The booklet discusses
the types of emotions that children may feel while grieving
for an infant sibling who has died, including fear, anger,
guilt, and sadness. The booklet also discusses when parents
or others should worry about a child's reactions to the death;
the importance of everyone talking about the death; what one
should and should not say about where the baby went; siblings'
participation in the funeral; ways in which siblings can remember
the brother or sister who died; and how the level of understanding
of death differs with a child's age.
Available from:
California SIDS Program
11344 Coloma Road, Suite 560
Gold River, CA 95670-6304
(916) 851-7437
(800) 369-7437 (in CA)
(916) 851-5937 (Fax)
info@californiasids.com (E-mail)
http://www.californiasids.com
California Department of Health Services,
Maternal and Child Health Branch
Sudden Infant Death Syndrome: What Childcare Providers
and Other Caregivers Should Know.
Rancho Cordova, CA: California SIDS Program. 2001. 13 p.
This booklet provides child care providers
with information about sudden infant death syndrome (SIDS).
The booklet covers the following topics: basic facts about
SIDS, to help reduce the risk of SIDS, emergency procedures
the child care provider should follow in a suspected SIDS case,
how the child care provider may feel after the death, the investigative
process that the law requires after every unexplained infant
death and questions that investigators will probably ask the
provider, how to explain the death to the other children in
the child care group, questions to expect from the parents
of the SIDS victim, and questions to expect from other parents
whose children also are in the provider's care. The booklet
stresses over and over that no one is to blame for a SIDS death.
A form for recording emergency telephone numbers is included.
Available from:
California SIDS Program
11344 Coloma Road, Suite 560
Gold River, CA 95670-6304
(916) 851-7437
(800) 369-7437 (in CA)
(916) 851-5937 (Fax)
info@californiasids.com (E-mail)
http://www.californiasids.com
California Department of Health Services,
Maternal and Child Health Branch
Sindrome de muerte infantil repentina (SIDS): Lo
que deben saber las guarderias infantiles y personas que
cuidan ninos [Sudden Infant Death Syndrome (SIDS): What Childcare Providers and Other Caregivers Should Know].
Rancho Cordova, CA: California SIDS Program. 2001. 13 p.
This booklet provides Spanish-speaking child
care providers with information about sudden infant death syndrome
(SIDS). The booklet covers the following topics: basic facts
about SIDS, emergency procedures the child care provider should
follow in a suspected SIDS case, how the child care provider
may feel after the death, the investigative process that the
law requires after every unexplained infant death and questions
that investigators will probably ask the provider, how to explain
the death to the other children in the child care group, questions
to expect from the parents of the SIDS victim, and questions
to expect from other parents whose children also are in the
provider's care. The booklet stresses over and over that no
one is to blame for a SIDS death. A form for recording emergency
telephone numbers is included.
Available from:
California SIDS Program
11344 Coloma Road, Suite 560
Gold River, CA 95670-6304
(916) 851-7437
(800) 369-7437 (in CA)
(916) 851-5937 (Fax)
info@californiasids.com (E-mail)
http://www.californiasids.com
Moon RY, Biliter WM, Croskell SE.
Examination of State Regulations Regarding Infants
and Sleep in Licensed Child Care Centers and Family Child
Care Settings.
Pediatrics 107(5): 1029-1036, May 2001.
Twenty percent of sudden infant death syndrome
(SIDS) occurs in childcare settings. Although the incidence
of SIDS in the United States has decreased with increased awareness
of the risks of prone infant sleeping, smoke exposure, soft
bedding, and unsafe sleep environments, avoidance of these
risk factors is not universally practiced in child care settings.
Advocacy through state childcare regulatory agencies and legislative
bodies may be effective in more widespread awareness and avoidance
of risk factors. The objective of this study was to determine
what individual state regulations for licensed child care centers
and family child care settings exist regarding: 1) sleep positions
for infants under 6 months old, 2) crib safety, 3) bedding
safety, and 4) smoking in the facilities. A descriptive survey
of regulations for licensed childcare centers and family childcare
settings in the 50 states and the District of Columbia were
examined. Fifteen states use regulations adopted before publication
of the first policy statement of the American Academy of Pediatrics
on infant sleep position and SIDS in 1992. Six states require
childcare centers to place infants non prone. Sixty-three percent
of states require cribs in child care centers to meet at least
one safety standard, and 45.1 percent require this in family
child care homes. Six states have provisions limiting the use
of soft bedding in child care centers, and four have such bans
for family child care homes. Seventy-one percent of states
prohibit smoking in childcare centers during hours of operation;
17 percent of states have similar requirements for family childcare
homes. It was concluded that many states use childcare regulations
that were written before the initial policy statements of the
American Academy of Pediatrics regarding safe sleep environments
for infants. Even those more recently adopted regulations do
not adequately address sleep safety for infants. Pediatricians
need to become more proactive in promoting safety regulations
in child care. Adoption of new regulations can aid in education
of childcare providers and, thus, improve the safety for infants
in childcare.
Free full-text downloading available at: http://pediatrics.aappublications.org/cgi/reprint/107/5/1029
National SIDS /ID Program Support Center
(NSIDPSC), Infant Mortality Risk Reduction Work Team
Sudden Infant Death Syndrome and the Child Care Provider.
Rockville, MD: Health Resources and Services Administration
(DHHS/PHS), Maternal and Child Health Bureau. April 2000. 4
p.
This brochure is intended to educate childcare
providers about SIDS and its risk factors. Childcare providers
who do not follow current recommendations for infant sleep
position and bedding may be subject to legal action if an infant
dies of SIDS while in their care. The law requires a police
investigation in all cases of unexplained death. Providers
who have lost an infant to SIDS will be questioned by the police
as well as by licensing and insurance agencies. The police
investigation may be difficult for the provider and others
close to the infant, but it is important in that it helps determine
the cause of the infant's death, helps everyone learn more
about SIDS and other causes of infant death, and confirms that
no one was to blame for the infant's death. Childcare providers
can prepare for the possibility that an infant is found unresponsive
in their care by being educated in emergency procedures by
their local SIDS program, maintaining up-to-date infant CPR
certification, and conducting practice drills on what should
be done if an infant is found unresponsive in their care. Childcare
providers should discuss infant sleep position with all the
parents they deal with, and they should have specific policies
to address the issue. Nine important recommendations for reducing
the risk of SIDS are included.
Available from:
National SIDS/ ID Program Support Center (NSIDPSC)
1314 Bedford Avenue, Suite 210
Baltimore, MD 21208
(800) 221-7437 (Toll-free)
(410) 415-6628
(410) 653-8709 (Fax)
kathleen.graham@firstcandle.org (E-mail)
http://firstcandle.org/health/health_support.html
Free full-text downloading available at: http://firstcandle.org/FC-PDF3/sids%20&%20child%20care%20provider.pdf
Moon RY, Patel KM, McDermott-Shaefer SJ.
Sudden Infant Death Syndrome in Child Care Settings.
Pediatrics 106(2): 295-300, August 2000.
The incidence of sudden infant death syndrome
(SIDS) in the United States has decreased with decreased prone
sleeping. Extrapolating from Census Bureau data, ~7 percent
of SIDS should occur in organized childcare settings (i.e.,
child care centers or family child care homes). However, 2
states have reported higher rates of SIDS in childcare. The
objective of this study was to determine the percentage of
SIDS deaths occurring in childcare settings, and to ascertain
associated factors. A retrospective study of SIDS deaths from
January 1995 through June 1997 was conducted. Data were abstracted
from SIDS databases in 11 states. Characteristics of SIDS cases
occurring in child care settings, including sleep position,
were compared with those occurring in the care of parents.
Univariate and multiple logistic regression analyses were performed.
Results showed that out of a total of 1916 SIDS cases analyzed
for this study 20.4 percent death occurred in child care settings.
Compared with deaths in the care of parents, those occurring
in child care settings were more likely to occur on weekdays
between 8:00 AM and 4:00 PM; infants were older; not black;
and their mothers were more educated. Infants in childcare
were more likely to be found prone in univariate analysis,
but the association was not significant in multiple logistic
regression analysis. However, in multiple regression analysis,
infants in childcare were more likely to be last placed prone
or found prone, when the usual sleep position was side or supine.
Conclusions indicate a large proportion (20.4 percent) of SIDS
cases occur in childcare settings. Factors associated with
SIDS in childcare settings include older age, race, and highly
educated parents. Previous studies have reported that unaccustomed
prone sleeping puts infants at high risk with SIDS in childcare
and may partly explain the high proportion of SIDS cases in
child care settings. Parents must discuss sleep position with
any caretakers of their infants. In addition, further efforts
to educate childcare providers about the importance of supine
sleep for infants must be ongoing.
Free full-text downloading available at: http://pediatrics.aappublications.org/cgi/reprint/106/2/295
California Department of Health Services,
Maternal and Child Health Branch Sudden Infant Death Syndrome:
Training Guide for Training of Emergency Personnel Rancho Cordova,
CA: California Sudden Infant Death Syndrome Program. 2000.
This trainer’s guide is
intended to prepare emergency personnel for their role in supporting
SIDS family members, childcare providers, foster parents, and
other caregivers at a critical time. This guide provides tools
needed to present a series of training modules on SIDS. Each
module can be presented individually at different times or
in one session for a total training time of two hours. Guide
is organized into six chapters.
Available from:
California SIDS Program
11344 Coloma Road, Suite 560
Gold River, CA 95670-6304
(916) 851-7437
(800) 369-7437 (in CA)
(916) 851-5937 (Fax)
info@californiasids.com (E-mail)
http://www.californiasids.com
Cullen A, Kiberd B, McDonnell M, et al.
Sudden infant death syndrome--are parents getting
the message?
Irish Jrl Medical Science 169(1):40-43, Jan-Mar 2000.
Background: Factors that place an infant
at increased risk of sudden infant death include the prone
sleep position, overheating and parental smoking, while practices
such as bottle-feeding, co-sleeping and the use of pacifiers
remain controversial. Major publicity campaigns have been undertaken,
which have included the distribution of printed material and
extensive media coverage. Aims: To examine if Irish parents
follow the currently recommended childcare guidelines to reduce
the risk of sudden infant death and to examine factors that
may have impact on their acceptance. Methods: A random selection
of 197 infants from the Birth Register of the Eastern Health
Board. Parents were interviewed and a semi-structured survey
questionnaire was completed. Results: Forty one per cent of
infants are still placed on their side to sleep, an inherently
unstable position. First time parents are more likely to place
their infants on their backs. Over 60% of infants are exposed
to one or more adults smoking in the home despite parental
knowledge of its association with sudden infant death syndrome
(SIDS). Sixty eight percent of infants are over wrapped at
night and parental understanding of what constitutes over wrapping
is poor. Thirteen per cent of infants regularly co-sleep with
their parents and 20% of these parents smoke. Pacifier use
is common. Conclusions: Future programmes should target first
time parents, should provide clear information regarding appropriate
infant thermal environment, and should ensure regular updating
of medical personnel so that they can instruct families on
best current practice. Smoking remains a significant health
issue with an impact on sudden infant death.
For Full-text: http://www.ijms.ie/Portals/_IJMS/Documents/169140.pdf
Moon RY, Biliter WM.
Infant Sleep Position Policies in Licensed Child
Care Centers after Back to Sleep Campaign.
Pediatrics 106(3): 576-580, September 2000.
Background: Since the Back to Sleep (BTS)
campaign was initiated in 1994, the rate of prone sleeping
has decreased to approximately 20 percent. However, childcare
centers may have an increased rate of prone sleeping in infants.
In 1996, a study of licensed childcare centers demonstrated
that 43 percent were unaware of the association between sudden
infant death syndrome (SIDS) and prone sleeping and that 49
percent positioned infants prone. Objective: To determine effectiveness
of a mailing from the BTS campaign to licensed child care centers
by assessing the following: 1) child care center awareness
of the recommendations of the American Academy of Pediatrics
regarding infant sleep position and 2) implementation of the
recommendations of the American Academy of Pediatrics in child
care center practice. Design: A descriptive, cross-sectional
survey of licensed childcare centers in the metropolitan Washington,
DC, region. All licensed child care centers caring for infants <6
months old in Washington, DC, and Montgomery, Prince Georges,
Howard, Anne Arundel, Frederick, and Charles Counties in Maryland
were recruited for the study. Results: Out of 236 eligible
centers, 172 completed the survey. Seventy-five percent (129)
of the centers were aware of recommendations regarding infant
sleep position. Infants were placed prone in 27.9 percent of
centers, although only 2.9 percent placed infants exclusively
in the prone position. The most common reasons for avoiding
prone position entirely were SIDS risk reduction and licensing
regulations. Half of the centers had a written policy regarding
sleep position. Twenty centers who were aware of the dangers
of prone sleeping continued to place infants prone at least
some of the time, largely because of parental request. Only
56.9 percent of centers had heard of the BTS campaign despite
the mass mailing. The mailing resulted in policy change for
14 centers. Conclusions: Since 1996, the percentage of licensed
child care centers in the greater Washington, DC, area that
are aware of the association between SIDS and infant sleep
position has increased from 57 percent to 75 percent. In addition,
the rate of placing infants prone in these centers has declined
from 49 percent in 1996 to 27.9 percent in this study. When
childcare centers are aware of the risk of prone sleeping,
the most likely reason for continued prone placement is parental
request. Although media and mailings have been largely effective
in communicating BTS information to many childcare centers,
non prone positioning is not universal among childcare providers.
Additional educational efforts toward child care providers
and parents remain necessary.
Free full-text downloading available at: http://pediatrics.aappublications.org/cgi/reprint/106/3/576
First Candle/SIDS Alliance
Sudden Infant Death Syndrome: Surviving the Death
of a Baby.
Baltimore, MD: SIDS Alliance. 2000. 11 p.
This brochure serves as an aid to parents
who have lost a baby to Sudden Infant Death Syndrome (SIDS).
It covers topics like grieving process parents undergo, coping
with birthdays, anniversaries and holidays, trying for another
baby, children's reactions to death, how grandparents undergo
double grief, how childcare providers react to the grief. Furnishes
contact information to stop unsolicited reminders of the baby's
death. Presents suggestions to friends and relatives in a do's
and don'ts format to assist SIDS parent’s
grief. Includes two poems entitled "Last day" by Deborah R.
Gemmill and "The journey of living on" by Sharon A. Dunn.
Available from:
National SIDS/ID Program Support Center (NSIDPSC)
1314 Bedford Avenue, Suite 210
Baltimore, MD 21208
(410) 415-6628
(800) 221-7437 (Toll-free)
(410) 653-8709 (Fax)
kathleen.graham@firstcandle.org (E-mail)
http://firstcandle.org/health/health_human.html
Free full-text downloading available at: http://firstcandle.org/FC-PDF3/surviving.pdf
Nelson EAS, Taylor BJ, et al.
International Child Care Practices Study: Infant
Sleeping Environment.
Early Human Development 62(1): 43-55, April 2001.
The International Child Care Practices Study
(ICCPS) has collected descriptive data from 21 centers in 17
countries. In this report, data are presented on the infant
sleeping environment with the main focus being sudden infant
death syndrome (SIDS) risk factors ( bed sharing and infant
using a pillow) and protective factors (infant sharing a room
with adult) that are not yet well established in the literature.
Using a standardized protocol, parents of infants were surveyed
at birth by interview and at 3 months of age mainly by postal
questionnaire. Centers were grouped according to geographic
location. Also indicated was the level of SIDS awareness in
the community, i.e., whether any campaigns or messages to "reduce
the risks of SIDS" were available at the time of the survey.
Results showed that birth interview data were available for
5488 individual families and 4656 (85 percent) returned questionnaires
at 3 months. Rates of bed sharing varied considerably (2-88
percent) and it appeared to be more common in the samples with
a lower awareness of SIDS, but not necessarily a high SIDS
rate. Countries with higher rates of bed sharing appeared to
have a greater proportion of infant’s bed
sharing for a longer duration (>5 h). Rates of room sharing
varied (58-100 percent) with some of the lowest rates noted
in centers with a higher awareness of SIDS. Rates of pillow
use ranged from 4 percent to 95 percent. Conclusions showed
that it is likely that methods of bed sharing differ cross-culturally,
and although further details were sought on different bed sharing
practices, it was not possible to build up a composite picture
of "typical" bed sharing practices in these different communities.
These data highlight interesting patterns in childcare in these
diverse populations. Although these results should not be used
to imply that any particular childcare practice either increases
or decreases the risk of SIDS, these findings should help to
inject caution into the process of developing SIDS prevention
campaigns for non-Western cultures.
Full-text available at: http://www.sciencedirect.com/science/journal/03783782
Green, M. and Palfrey, J. S. (Eds.).
Bright Futures: Guidelines for health supervision
of infants, children, and adolescents. (2nd ed.) (Rev.).
Arlington, VA: National Center for Education in Maternal and
Child Health, 2001. 338 pp.
These Bright Futures guidelines provide health
professionals and families with practical information, effective
preventive techniques, and health promotion materials. The
guidelines begin with a brief description of the Bright Futures
program and an introduction to health supervision. Individual
chapters focus on infancy, early childhood, middle childhood,
and adolescence. Each chapter covers age-specific information
about the preparation families can do before a health visit,
strengths and issues of the age group, and developmental charts.
Appendices include (1) the Bright Futures periodicity schedule,
(2) medical history, (3) recommended immunization schedule,
(4) hearing screening, (5) vision screening, (6) iron-deficiency
anemia screening, (7) screening for elevated blood lead levels,
(8) hyperlipidemia screening, (9) hypertension screening, (10)
tooth eruption chart, (11) sexual maturity ratings, (12) sexually
transmitted disease prevention and screening, (13) safe, quality
child care, (14) a bibliography, and (15) a list of participants
in the first edition of these guidelines. [Funded by the Maternal and Child Health Bureau]
Free full-text downloading at: http://www.brightfutures.org/bf2/pdf/index.html.
National Conference of State Legislatures
This website provides summary of Sudden Infant
Death Syndrome (SIDS) laws from 50 states. Offers a brief description
of each law with links to more information.
http://www.ncsl.org/programs/health/sidsleg.htm
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