Infant/Toddler Safe Sleep & SIDS Risk Reduction in Child Care NEWSLETTER

One thousand and fifty (1,050) infants died in 2004 according to the latest infant mortality statistics officially released by the State Center for Health Statistics on August 11, 2005. Unfortunately, this is a 7.3% increase in the number of infant deaths compared to the previous year. The infant death rate for 2004 is 8.8 per 1,000 live births compared to 8.2 in 2003. It will be important to monitor infant deaths closely over coming years to fully understand the trends. The health disparity in infant deaths continues with African American babies dying at a rate twice that of Whites, an issue of grave concern to public health practitioners and communities.

The four specific leading causes of infant death for 2004 mirror previous years and include: (l) birth defects, (2) premature births and low birth weight, (3) SIDS, and (4) respiratory distress and other respiratory conditions. For a table listing the causes click on the following link: http://www.schs.state.nc.us/SCHS/deaths/ims/2004/table7.html.

One-hundred and three (103) SIDS deaths were reported, accounting for 9.8% of the overall infant deaths in 2004. The SIDS rate of .86 per 1,000 live births in 2004 remained similar to the SIDS rate reported the previous year (.84 per 1,000 live births). The N.C. SIDS Program and the state's Child Fatality Task Force indicate a growing number of infant deaths associated with co-sleeping situations in which the baby was bed-sharing with a parent. Promoting infant sleep safety and a safe sleep environment at home needs to be continually reinforced.

Data received from the State Center for Health Statistics for 101 of the 103 SIDS deaths indicate that:

• One-half (49%) of North Carolina counties experienced a SIDS death.
• There was no gender difference in SIDS deaths, with a 50% distribution among males and female infants.
• 95% of SIDS deaths occurred by six months of age.
• 48% of SIDS deaths occurred during 2-4 months of age.
• More White infants, 55% of SIDS deaths, died compared to African Americans (41%), American Indians (2%), Hispanics (1%) or "Other" race (1%).
• 48% of the mothers who lost an infant to SIDS were smokers.
• Although SIDS deaths were fairly evenly distributed throughout the year, more SIDS deaths (29%) did occur during the winter months of December, January and February.

For additional infant mortality data go the State Center for Health Statistics' Web site at http://www.schs.state.nc.us/SCHS/deaths/ims/2004/.
To view infant death rates by perinatal region and by county, click on the following link: http://www.schs.state.nc.us/SCHS/deaths/ims/2004/fiveyear.html.

The Consumer Product Safety Commission (CPSC) and leading SIDS risk reduction organizations such as the American Academy of Pediatrics and the First Candle/SIDS Alliance are still advocating that safe sleep environments do not include soft bedding in cribs. Consumers Union, publishers of the popular magazine, Consumer Reports, agrees.

The Juvenile Products Manufacturing Association (JPMA), the trade group for infant bedding, bumper pads, toys and cribs doesn't agree. Last year, the JPMA launched a publicity campaign suggesting bedding and toys pose no risks to babies and indicated this finding was supported by the Consumer Product Safety Commission.

A Consumer Reports investigation found that the CPSC had reviewed deaths in cribs involving only suffocation or strangulation. SIDS deaths were not included in their review. However, contrary to the JPMA's statement, the CPSC did find that bedding, primarily adult bedding, was implicated in infant deaths due to suffocation. Parents and caregivers are still advised not to use soft bedding in cribs, for baby's safety.

To read this article click here:

Regulatory - Training requirements

Q: A child care center director wants to know who needs to have the SIDS training. Her lead teacher leaves around 3:00 PM and has an aide come in from 3:00-6:00 PM. Does this person need to be trained? Same question regarding substitutes who come in if the teacher is sick.

A: The childcare licensing rules state that lead infant teachers/owners/operators/directors, substitutes and volunteers counted in the child-to-staff ratio are required to be ITS-SIDS certified (trained). Many directors are having all of their staff participate in the ITS-SIDS Training in the event that one of the staff is asked to substitute in the infant room. Better to be safe for baby's sake and to reduce liability for childcare providers and ensure that the safe sleep policy is being carried out.

Photos - Promoting your safe sleep message

Q: I need a picture of a baby sleeping on his back for our newsletter. Do you have one you can send me or can you direct me to some photos?

A: The ITS-SIDS Curriculum 4th Edition CD that was shipped to you in December has an image of Patrick, our Back To Sleep poster-child, for you to use. Simply access the CD, click on the image, copy, paste into your newsletter document and then resize the image to your desired specifications.

When using graphics to illustrate "back to sleep" it is important that your images clearly and consistently reflect our key SIDS risk reduction messages. Secondly, you will want a high resolution image for a clear, crisp, quality photograph.

The internet is a gold mine of images but use common sense when accessing them for your own materials. Some photos/images are in the public domain and can be used free-of-charge and without permission. Others have copyright restrictions and may require permission as well as fees. You can conduct a Google search for images from the Google website. A host of photos will appear (including our Patrick on the N.C. Back To Sleep materials). Some of these photos depict infants in unsafe sleeping situations which are contrary to our infant sleep safety messages. Keep in mind that the resolution of graphics from other's websites may be too poor for a crisp image in your printed format.

It is a wise practice to make sure any photos you download from the internet are in the public domain and are royalty free. It is a professional courtesy to contact the owner of the photos in which you are interested and always obtain written permission for their use. To model a clear and consistent "stomach to play...back to sleep" message for reducing SIDS risks and promoting healthy development choose the images you use with care and make sure they also follow infant sleep safety and SIDS risk reduction standards of care.

In celebration of Baby Safety Month the First Candle/SIDS Alliance supports local partnerships with Babies "R" Us stores nationwide as they focus their lens on baby safety. This is a wonderful opportunity to promote infant sleep safety and SIDS risk reduction in your community and among parents, grandparents and extended families.

Act now! Contact your local Babies "R" Us Store Promotional Coordinator to see if you can set up a display or informational table, provide a crib safety demonstration, and give a parent-education talk on Saturday, September 24th from 12 - 4 PM. The company only asks that messages remain positive and upbeat - in terms of talking about what parents (new and expecting) can do to reduce their baby's risk of infant death.

The Parent Center web site for pregnant women and for parents is also a helpful tool for early childhood specialists and childcare providers too! This user-friendly website addresses children's cognitive, social/emotional and physical development, as well as health and safety issues that every provider wants to know about. Click here to access this resource:

Add Great Beginnings to your list of great web-based resources for parents of infants and young children and childcare providers. The "Learning About Your One Month Old" series explores topics ranging from infant sleeping and development patterns to choosing child care. Share this resource with parents and providers: http://ag.udel.edu/extension/ fam/gb/1month/gb-1m.htm.

In June 2005, the North Carolina Healthy Start Foundation's website was updated. The site was redesigned for two major audiences - parents and professionals. Check it out at www.NCHealthyStart.org.

ITS-SIDS web pages have been reorganized and include a section for childcare providers and for trainers (under the professional's category) at http://www.NCHealthyStart.org/ITS-SIDS/index.htm.

You may find additional questions and answers geared for childcare providers helpfu lat:
http://www.nchealthystart.org/ITS-SIDS/cc-qanda.htm.

Click on this link to access waivers, a sample policy and a sleep chart template: http://www.nchealthystart.org/ITS-SIDS/tr-rules.htm.

When SIDS does occur in a childcare setting, you may be contacted, so take a look at this section: http://www.nchealthystart.org/ITS-SIDS/tr-sids.htm.

When SIDS happens information for childcare providers at this link may be helpful:
http://www.nchealthystart.org/ITS-SIDS/cc-sids.htm.

TIP: Ordering Materials from North Carolina Healthy Start Foundation

You'll also notice that our Order Form has changed and that the Safe Sleep Rules for Caregivers is no longer listed on the order form. It will continue to be available until supplies run out. To order copies of the Safe Sleep Rules for Caregivers you will need to FAX or mail your order and write in your request and specify the quantity at the bottom of the order form. When ordering, always remember to write "ITS-SIDS Trainer" after your name. Example: Eve Adams, ITS-SIDS Trainer

On June 30, 2005, the ITS-SIDS Project completed three years. During this time, ITS-SIDS trainers have done a stellar job! You have trained and assisted 30,858 childcare providers and completed or scheduled 1,713 trainings. CONGRATULATIONS! Your commitment, hard work and enthusiasm to this project have contributed to improved safety throughout North Carolina's childcare.

Phase 1 - 11,862 childcare providers; 616 trainings scheduled or completed
Phase 2 - 11,283 childcare providers; 595 trainings scheduled or completed
Phase 3A - 5,633 childcare providers; 312 trainings scheduled or completed
Phase 3B - 2,080 childcare providers; 190 trainings scheduled or completed

PHASE 4

We are now recruiting for ITS-SIDS In-Depth TA Training participants. Enrollments will be limited.

If you are interested in participating in the In-Depth TA Training send an email to:
[email protected]. In the subject line put: "Sign me up - In-Depth TA Training"
In the body of your email include:

1. Trainer Name and any updated contact information
2. County Name
3. Most challenging situation you encountered with infant safe sleep policy in child care
4. Steps you took to address this challenge

The In-Depth TA four-hour training will be scheduled in early December in several regions across the state. We will keep you updated.