Infant/Toddler
Safe Sleep & SIDS Risk Reduction in Child Care
NEWSLETTER
|
Infant/Toddler
Safe Sleep & SIDS Risk Reduction in Child Care |
| May 2006 | Volume
5 |
Number
1 |
Stomach
To Play...Back To Sleep ~ for baby's health and safety |
American
Academy of Pediatrics Updates |
In this issue: |
| Recent data from two N.C. surveys, the Pregnancy Risk Assessment Monitoring System (PRAMS) and the Behavioral Risk Factor Surveillance Survey (BRFSS) provide county data that illuminates SIDS risk factors. Proposed changes to infant death scene investigations nationwide should contribute to greater understanding of SIDS and other infant deaths. | - State
data sources shed light on SIDS risks |
| Pregnancy Risk Assessment Monitoring System (PRAMS) Data - 2003 |
Newly released 2003 Pregnancy Risk Assessment Monitoring System (PRAMS) data is available on the State Center for Health Statistics' web site. The goal of PRAMS is to improve the health of mothers and babies in North Carolina.
ITS-SIDS trainers are familiar with PRAMS, an ongoing mail/telephone survey of women who have recently given birth. PRAMS data has been reviewed in the ITS-SIDS training and is the state's primary measure of infant sleep positioning. PRAMS examines a host of health indicators surrounding pregnancy and birth outcomes, including: pregnancy intention; tobacco, alcohol and drug use before and during pregnancy; secondhand smoke exposure before and after the baby is born; breast feeding practices; women's safety; and access to health information and services.
For a topic
list of PRAMS data tables, click on the following link:
http://www.schs.state.nc.us/SCHS/prams/2003/
Infant Sleep Position
The 2003
PRAMS data shows that most N.C. infants continue to be positioned on their
back for sleeping. The number of infants placed on their side (16%) or stomach
(15%) was similar in 2003. Compared to 1998, the use of side sleep position
for infants dropped 21%, and the stomach sleep position decreased 6%. To access
the data on sleep position, click on this link:
http://www.schs.state.nc.us/SCHS/prams/2003/SLEEPPOS.html
 |
 |
Graph:
Infant Sleep Position
2003 and 1998. PRAMS. |
|
Secondhand Smoke
Exposure
It is helpful to look
at tobacco use data because tobacco smoke exposure is a significant risk
factor for SIDS. This data can be used to help focus educational efforts
and outreach to lower SIDS risks. To gauge baby's tobacco smoke exposure,
survey respondents were asked: "Is you new baby ever in the same room with someone who is
smoking?"
The data shows that most of North Carolinian's babies are not exposed to
secondhand smoke. Infants are more likely to be exposed to someone smoking
when the primary caregiver is less than 20 years of age, not married, has
a lower income or is a Medicaid recipient.
The Behavioral Risk Factor
Surveillance Survey (BRFSS) offers another measure of SIDS risk factors.
It is a random telephone survey of state residents 18 years of age or older
in households with a telephone. It is the longest running and largest telephone
health survey worldwide. The survey results reported for N.C. in 2004 reflect
results from 15,053 interviews conducted in English and Spanish. Besides
tobacco use and alcohol consumption, which are both significant SIDS risks,
BRFSS topics range from diabetes, women's health, specific immunizations
(flu), asthma and health status to environmental factors (mold, chemicals,
exhaust). County data for each survey question is accessible on-line at the
following link:
http://www.schs.state.nc.us/SCHS/brfss/2004/index.html.
The BRFSS data show that people living in rural areas are more likely to smoke than those in urban areas. Rowan, Onslow and Robeson counties reported the state's highest smoking rates. Wake, Orange and Union counties had the lowest smoking rates, about half the rate reported for the counties with the highest rates.
Adgent MA. Environmental
tobacco smoke and sudden infant death syndrome: A review.
Birth Defects Res B Dev Reprod Toxicol. 2006 Feb 22;77(1):69-85.
Secondhand smoke also referred to as environmental tobacco smoke (ETS) is a prevalent component of indoor air pollution and contains nicotine. Nicotine is a known developmental neurotoxin. Research shows that infants exposed to secondhand smoke in utero or after birth are exposed to nicotine, which concentrates in the fetus. Animal studies indicate that nicotine in varying doses negatively affects the newborn's response to low oxygen conditions (hypoxia), a process believed to be linked to SIDS. The researchers are examining how nicotine binds to cell receptors and are calling for more research about the effects of nicotine exposure, including secondhand smoke exposure, during pregnancy; they also discourage smoking near pregnant women and infants.
| Infant Death Scene Investigations |
For the first time, law enforcement, coroners and medical examiners will have the information they need to more accurately determine the cause of a child's death. The National Centers for Disease Control and Prevention (CDC) have released a Sudden Unexplained Infant Death Investigation (SUIDI) Reporting Form. The CDC will train state Medical Examiners and selected staff in 2006 at a series of regional trainings across the country. This initiative establishes national standards for data collection at infant death scene investigations.
| Crib Safety - Product Recall |
The U.S. Consumer Product Safety Commission (CPSC) and Simplicity Inc. recalled Graco Brand Aspen 3-in-1 cribs for suffocation risks in Release #06-058 issued in late December 2005 and again in February 2006. The crib has a Graco label but is manufactured by Simplicity. Wooden mattress supports on cribs with model number 8740KCW SC and serial number 2803 SC (made in 2003) to 1605 (made in 2005) were recalled. The model and serial number are printed on the envelope attached to the mattress support. The recalled cribs were sold in stores from August 2003 through May 2005 for about $130.
The primary hazard is that screws on the wooden mattress support can loosen causing a portion of the mattress to fall. This is an entrapment and suffocation hazard. Injuries reported included entrapment, scratches, bruises to the face and head, neck strain and infant death due to suffocation.
For more information or
to receive a retrofit kit, contact the Simplicity's Recall Hotline: (800)
784-1982 or visit their web site at:
www.simplicityforchildren.com.
Contact the CPSC Recall
Hotline (800) 638-2772 for additional information. To view this recall on
CPSC's web site or to see a picture of the recalled product, visit:
www.cpsc.gov/cpscpub/prerel/prhtml06/06058.html.
| Q&A Answers to Your Questions |
Q: Do
you still have the "Safe Sleep Rules for Caregivers" mini-posters?
I did not see it on the order form.
A: The
"Safe Sleep Rules for Caregivers" is not listed in the order form.
Current supplies are limited to ITS-SIDS trainers so you'll need to FAX your
order to 919-828-7470. Follow these instructions so that our shipper will know
to send "Safe Sleep Rules for Caregivers" to you.
IMPORTANT INFORMATION BEGINNING July 1, 2006
Q: When
centers revise their Safe Sleep Policy, do they give the revised policy out
to all the parents or just the parents of infants?
A: If
a center amends their Safe Sleep Policy, they must give written notice of the
amendment to parents of all children affected by the policy (infants age 12
months and younger) at least 14 days before the amended policy is to be implemented.
Each parent must sign a statement acknowledging receipt of the new policy and
explanation of the policy amendment. The signed statement must be retained
in the child's record as long as the child is enrolled at the child care facility.
This is required by Child Care Rule .0606(d). This also applies to family child
care homes as required by Child Care Rule .1724(d).
| Resources for Parents and Providers: |
The Health and
Well-being of Children: A Portrait of the States and the Nation 2005.
A new chart book lists state
data about children's health status, healthcare practices and access to services
(including Medical Home), school activities, family, and children in relation
to their neighborhood. The state level data is based on parent report to the
National Survey of Children's Health administered through the U.S. Department
of Health and Human Services, Health Resources and Services Administration,
Maternal and Child Health Bureau.
http://www.mchb.hrsa.gov/thechild/states/ncarolina.htm
Good Health Directory
- Home grown, this resource is North Carolina's own web-based
comprehensive referral directory of statewide resources, including healthcare
providers, programs, hospitals, and clinics. This resource assists healthcare
professionals and the general population in locating services, vendors,
and resources throughout the state that can help those ready to improve
their health. The directory is especially helpful in assisting individuals
in being physically active, eating healthy, and quitting all tobacco use
by linking them to resources in their own community. The N.C. Good Health
Directory, easily accessible at www.ncgoodhealthdirectory.com,
is a searchable database organized by county, city, and zip code.
FitSource: A
Web Directory for Providers contains a wide variety of tools that can be
used to incorporate physical activity and nutrition into child care and after-school
programs. The web site, produced by the Child Care Bureau, links to activities
and game ideas, curricula and lesson plans, campaigns, healthy menus and
recipes, funding strategies, information for parents, and other resources.
The web site allows users to search for resources by keyword or by age group
(infant and toddler, preschool, and school age), and includes links to resources
available in Spanish. The web site also contains a speaker's kit with PowerPoint
slides, notes, and handouts on the following topics: (1) childhood obesity
and overweight statistics; (2) consequences of childhood obesity; (3) why
child care and after-school settings are an ideal venue for incorporating
nutrition and physical activity; and (4) an overview of program, policy,
and finance strategies supporting nutrition and physical activity in child
care and after-school programs. The web site is intended for use by program
administrators, directors, technical assistance providers, and others interested
in promoting proper nutrition and physical activity in child care and after-school
settings. It is available at:
http://nccic.caliber.com/fitsource/index.cfm
Health and Safety
E-News for Caregivers. The
American Academy of Pediatrics Child Care and Health Partnership program
have launched an electronic newsletter for childcare providers. It offers
information on evidence-based practices that promote the health and safety
of children in child care. The first issue has information and action steps
on reducing the risk of Sudden Infant Death Syndrome (SIDS) and connecting
families to community resources: http://www.healthychildcare.org/CaregiverEnews.cfm.
Share this new resource with childcare providers.
| Project Update - Phase 4 |
ITS-SIDS trainers and In-Depth TA training participants are an innovative group! Ann Meletzke with Guilford County has taken the In-Depth TA training one-step further than strictly giving technical assistance to childcare providers.
Ann offered the same In-Depth TA training to childcare directors in Guilford County. They received credit hours in exchange for a presentation about the rule and policy components required for infant safe sleep. While this training covers licensing requirements around infant safe sleep, it is not the same as the ITS-SIDS Training.
After the policy training, the directors will have an opportunity to sign up for technical assistance from the child care health consultant and the Alamance Partnership for Children. They will get further help refining and updating their Safe Sleep Policies. Additional credit hours cannot be offered to the directors for the TA, but they appreciate the extra help.
If you are interested in providing In-Depth TA training using the same materials from the train-the-trainer session, please email Chris O'Meara at [email protected].