Infant Sleep Safety: Understanding Risks and Exploring Safety Measures

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Presentation for parents and caregivers to promote safe sleep for infants, to reduce the risk of sudden infant death. Based on Safe to Sleep® information and guidelines put forth by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the American Academy of Pediatrics.

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Infant Sleep Safety: Understanding Risks and Exploring Safety Measures

  1. 1. Infant Sleep Safety Understanding Risks and Exploring Safety Measures
  2. 2. Today’s Agenda • Sudden infant death • Sleep position risk factors • What you can do to keep infants as safe as possible • What you can teach parents about risk reduction • Child’s grief • What to do if the unimaginable happens
  3. 3. Sudden Infant Death
  4. 4. What is SIDS? Sudden Infant Death Syndrome (SIDS) is the sudden death of an infant under one year of age which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene and review of the clinical history.
  5. 5. What is SIDS? SIDS is a diagnosis of exclusion, assigned only once all known and possible causes of death have been ruled out
  6. 6. What is SIDS? SIDS is the leading cause of death among infants ages one month to one year. SIDS claims the lives of almost 2,500 infants in the US each year - that's nearly 7 babies every day.
  7. 7. SIDS Triple Risk Model The greatest risk for SIDS happens here The greatest risk for SIDS happens here SIDS is believed to result from the intersection of three overlapping factors
  8. 8. SIDS Triple Risk Model The greatest risk for SIDS happens here The greatest risk for SIDS happens here Risk-free and single-risk SIDS cases are rare, and most contain at least two of these risks.
  9. 9. SIDS Triple Risk Model The greatest risk for SIDS happens here The greatest risk for SIDS happens here As a parent or care provider, it is important to learn about these risks and what you can do to reduce the risk of SIDS.
  10. 10. An underlying defect or brain abnormality makes the baby vulnerable. In the triple risk model, certain factors, such as defects in the parts of the brain that control respiration or heart rate, or genetic mutations, confer vulnerability.
  11. 11. Risk is highest in the infant’s first six months of life. 2-4 months is the most vulnerable time.
  12. 12. Babies experience rapid growth & change; bodies react with abrupt changes in heart rate, blood pressure, & body temperature. Paired with other factors, these changes can make an infant more vulnerable to SIDS.
  13. 13. Babies experience rapid growth & change; bodies react with abrupt changes in heart rate, blood pressure, & body temperature. Paired with other factors, these changes can make an infant more vulnerable to SIDS.
  14. 14. Most babies encounter and survive environmental stressors, e.g. second-hand smoke, overheating, a stomach sleep position, or upper-respiratory infection.
  15. 15. However, an already-vulnerable infant may not be able to overcome them.
  16. 16. SUIDSudden Unexpected Infant Death SUID is used to refer to any infant death that is unexpected and initially unexplained. Fewer and fewer medical examiners and coroners are using SIDS (Sudden Infant Death Syndrome) as a cause of death.
  17. 17. SUIDSudden Unexpected Infant Death The fact that there is no national standard for terminology for these types of infant deaths and that medical examiners / coroners are increasingly reluctant to use SIDS as a cause of death has led to parental and bureaucratic confusion.
  18. 18. SUIDSudden Unexpected Infant Death SIDS SIDS deaths are one kind of SUID death
  19. 19. SUIDSudden Unexpected Infant Death SIDS suffocation asphyxiation unexplainedOther deaths are on the rise
  20. 20. Sleep Position Risk Factors
  21. 21. Babies who sleep in an adult bed **40x greater risk of death** Infants who sleep on their back **5x greater risk of death** Unaccustomed sleeping position – back to stomach **18x greater risk of death** Babies who sleep on soft bedding **5x greater risk of death**
  22. 22. SIDS in Child Care Two thirds of US infants younger than 1 year are in non-parental child care. Infants of employed mothers spend an average of 22 hours per week in child care. 32% of infants are in child care full-time.
  23. 23. According to these numbers: Less than 9% of SIDS deaths should occur in child care. However Approximately 20% of SIDS deaths occur while the infant is in the care of a non- parental caregiver.
  24. 24. Child Care Caution: Unaccustomed Stomach Sleeping **Unaccustomed Stomach sleeping increases the risk of SIDS at least 18 times** Open communication with all caregivers is important in order to keep infants safe.
  25. 25. What You Can Do to Keep Infants as Safe as Possible
  26. 26. What is “Safe to Sleep”?
  27. 27. What is “Safe to Sleep”? Safe to Sleep is an expansion of the original Back to Sleep campaign, which started in 1994. The Safe to Sleep campaign aims to educate parents, caregivers, and health care providers about ways to reduce the risk for SIDS and other sleep-related causes of infant death.
  28. 28. BACK SLEEPING Infants should be placed for sleep on their back for EVERY SLEEP!!
  29. 29. USE A FIRM SLEEP SURFACE An infant should sleep in a safety approved crib or pack-and-play, with a firm, tight-fitting mattress and fitted sheet.
  30. 30. USE A FIRM SLEEP SURFACE Infants should not be placed for sleep on adult beds because of the risk of entrapment and suffocation. Car safety seats, strollers swings, infant carriers, and infant slings, are not recommended for routine sleep in the hospital or at home.
  31. 31. OFFER A PACIFIER AT NAP TIME AND BED TIME Do not attach the pacifier to the infant’s clothing or have a string attached to it. If the pacifier falls out while the infant is sleeping, do not force it back in.
  32. 32. OFFER A PACIFIER AT NAP TIME AND BED TIME For breastfed infants, delay the introduction until breastfeeding has been firmly established, usually 3-4 weeks of age.
  33. 33. KEEP SOFT OBJECTS AND LOOSE BEDDING OUT OF THE CRIB This includes pillows, quilts, comforters, any type of bumper pad, stuffed toys, blankets, and other soft objects.
  34. 34. AVOID OVERHEATING Infants should be dressed appropriately for the environment. General rule of thumb: no more than one layer more than an adult would wear to be comfortable in the environment.
  35. 35. AVOID OVERHEATING Infants should be evaluated for signs of overheating: sweating, or the infant’s chest feeling hot to the touch. Over-bundling and covering the face and head should be avoided.
  36. 36. AVOID COMMERCIAL DEVICES MARKETED TO REDUCE THE RISK OF SIDS There is no evidence that these devices reduce the risk of SIDS or suffocation or that they are safe.
  37. 37. AVOID COMMERCIAL DEVICES MARKETED TO REDUCE THE RISK OF SIDS It is also recommended not to use movement monitors or other devices as a way to reduce the risk of SIDS. (Examples: wedges, positioners, special mattresses, special sleep surfaces)
  38. 38. PROVIDE SUPERVISED, AWAKE TUMMY TIME This helps facilitate development and minimize the possibility of positional plagiocephaly
  39. 39. What You Can Teach Parents about Risk Reduction
  40. 40. ROOM SHARING, NOT BED SHARING Evidence is mounting that bed sharing significantly increases the risk of sudden infant death.
  41. 41. ROOM SHARING, NOT BED SHARING Infants may be brought into bed for feeding or comforting but should be returned to their own crib or bassinet when parent is ready to sleep.
  42. 42. ROOM SHARING, NOT BED SHARING Because of the extremely high risk of SIDS and suffocation on couches and armchairs, infants should not be fed on a couch or armchair when there is risk that the parent might fall asleep.
  43. 43. REGULAR PRENATAL CARE There is evidence linking a lower risk of SIDS for infants whose mothers obtain regular prenatal care.
  44. 44. AVOID SMOKING, ALCOHOL, AND ILLICIT DRUG USE DURING PREGNANCY AND AFTER BIRTH
  45. 45. Maternal smoking during pregnancy increases the baby’s risk for SIDS 3 times. Maternal smoking increases chances of a premature birth and low birth weight. These are risk factors for SIDS. After sleep position, smoke exposure is the most important risk factor for SIDS.
  46. 46. If a baby breathes secondhand smoke, there is a 2.5 times higher risk for SIDS. The risk is dose-dependent, higher with increasing exposure. Two parents who smoke increases risk more than if one parent smokes. Babies exposed to smoke don’t arouse/wake up as easily as babies not exposed to smoke.
  47. 47. Remember: Both maternal smoking during pregnancy and smoke in the infant’s environment after birth are major risk factors for SIDS.
  48. 48. BREAST FEEDING IS RECOMMENDED Breast feeding is associated with a reduced risk of SIDS.
  49. 49. IMMUNIZATIONS Infants should be immunized in accordance with recommendations from the AAP and Centers for Disease Control and Prevention.
  50. 50. Name the Risks in this Picture!
  51. 51. A Model of Safe Sleep What do you notice?
  52. 52. Child’s Grief
  53. 53. Child’s Grief Talk to children about death using language they can understand. Answer questions honestly. Allow them to express feelings; let them know feelings are not “right” or “wrong”
  54. 54. Child’s Grief Talk about the loss many times, in different ways. Reassure children the death was not their fault. Be comforting, provide attention, and show affection.
  55. 55. Age birth to 3 Affected by the mood of caregivers. May have changes in eating and sleep patterns. Maintain routines, and provide love, attention, and reassurance.
  56. 56. Age 3 to 6 Does not understand permanence of death; may think deceased is cold or hungry. May be afraid to sleep; may revert to earlier behaviors. Repeats questions, and fears self or others will die. Maintain routines, answer questions honestly, use concrete terms, allow expression of feelings.
  57. 57. Age 6 to 9 May feel responsible. May or may not show signs of distress. Fear loss or abandonment by family members. Maintain routines, answer questions honestly, allow expression of feelings, and reassure the death was not their fault.
  58. 58. Age 9 to 12 Understand death is permanent, and may see death as punishment for bad deeds. May show anger, guilt, grief, and physical symptoms. Provide time and affection and be honest about your own feelings. Contact the child’s teachers.
  59. 59. Teens May feel confused, sad, guilty, angry, lonely, or afraid, as well as physical symptoms. May hide feelings to protect parents, and assume responsibility for family well-being. Be willing to talk in teens time frame, without criticizing or judging; allow time alone to process his or her own way. Be honest about your own feelings.
  60. 60. What to do if the unimaginable happens?
  61. 61. Angel Eyes Mission Statement Helping families and others cope with the sudden, unexpected death of an infant or toddler, while raising awareness, providing education and supporting research about sudden, unexpected infant and toddler death.
  62. 62. Our Bereavement Services • Support groups • Grief Counseling for Adults, Families, and Children • Peer Contact Program • Referrals • All of our services are offered free of charge
  63. 63. Questions or Comments?
  64. 64. 425 South Cherry Street, Suite 560 Denver, CO 80246 Phone: 303-320-7771 Fax: 303-320-7827 www.angeleyes.org info@angeleyes.org www.facebook.com/pages/Angel-Eyes
  65. 65. Resources American Academy of Pediatrics Dedicated to the Health of all Children - www.aap.org
  66. 66. Resources CJ Foundation National non-profit devoted to eliminating the tragedy of sudden unexpected infant deaths and early childhood deaths, supporting grieving families, advancing medical research, furthering parent and professional education, and advocating for the health and survival of all children. http://www.cjsids.org
  67. 67. Resources National Institute of Child Health and Human Development (NICHD) Dedicated to supporting the world's best minds in investigating human development throughout the entire life process, focusing on understanding developmental disabilities, including intellectual and developmental disabilities (IDDs), and illuminating important events that occur during pregnancy. https://www.nichd.nih.gov/

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