SIDS AND SAFE SLEEP INFORMATION AND PREVENTION April 2009.

SIDS AND SAFE SLEEPSIDS AND SAFE SLEEP

INFORMATION AND INFORMATION AND PREVENTIONPREVENTION

April 2009

Training ObjectivesTraining Objectives

Identify what Sudden Infant Death Identify what Sudden Infant Death Syndrome (SIDS) is Syndrome (SIDS) is

Recognize the difference between SIDS Recognize the difference between SIDS and Infant Suffocationand Infant Suffocation

Recognize ways to prevent SIDS, Recognize ways to prevent SIDS, including the importance of a Safe Sleep including the importance of a Safe Sleep EnvironmentEnvironment

What is SIDS?What is SIDS?

Sudden Infant Death Syndrome (SIDS) is Sudden Infant Death Syndrome (SIDS) is the sudden death of an infant under 1 year the sudden death of an infant under 1 year of age, which remains unexplained after a of age, which remains unexplained after a thorough case investigation, including the thorough case investigation, including the performance of a complete autopsy, performance of a complete autopsy, examination of the death scene and examination of the death scene and review of the clinical history. review of the clinical history.

(Willinger et al., 1991)(Willinger et al., 1991)

Facts About SIDSFacts About SIDS

SIDS is the leading cause of death in SIDS is the leading cause of death in infants between 1 month and 1 year of infants between 1 month and 1 year of age. age.

Most SIDS deaths happen when babies Most SIDS deaths happen when babies are between 2 months and 4 months of are between 2 months and 4 months of age. age.

(National Institute of Child Health and Human Development)(National Institute of Child Health and Human Development)

Each year in the United States, more Each year in the United States, more than 4,500 infants die suddenly of no than 4,500 infants die suddenly of no obvious cause. Half of these deaths are obvious cause. Half of these deaths are diagnosed as SIDS. diagnosed as SIDS.

SIDS is more common in male babies.SIDS is more common in male babies.

SIDS is most common during winter SIDS is most common during winter months. months.

There are no known warning signs or There are no known warning signs or symptoms of SIDS. symptoms of SIDS. SIDS is not caused by spitting up, SIDS is not caused by spitting up, choking or illnesses such as the cold. choking or illnesses such as the cold. SIDS is not caused by immunizations. SIDS is not caused by immunizations. SIDS is not the cause of every sudden SIDS is not the cause of every sudden or unexpected infant death. or unexpected infant death. SIDS is not child abuse. SIDS is not child abuse.

While there are no known causes of While there are no known causes of SIDS, there are factors that have been SIDS, there are factors that have been identified as increasing an infant’s risk for identified as increasing an infant’s risk for sudden death: sudden death:

••Tummy (prone) or side sleepingTummy (prone) or side sleeping

••Bed SharingBed Sharing

••Soft Bedding and/or Loose BeddingSoft Bedding and/or Loose Bedding

• •SmokingSmoking

• •Preterm and low birth weight infantsPreterm and low birth weight infants

Facts About Infant Facts About Infant SuffocationSuffocation

Besides SIDS, parents have to also be Besides SIDS, parents have to also be careful regarding infants’ sleep careful regarding infants’ sleep environments. Most infant deaths due to environments. Most infant deaths due to suffocation are directly related to an suffocation are directly related to an unsafe sleep environment. unsafe sleep environment. Infants can suffocate when their faces Infants can suffocate when their faces become positioned against or buried in a become positioned against or buried in a mattress, cushion, wedge, pillow, mattress, cushion, wedge, pillow, comforter or bumper pad. comforter or bumper pad.

Infants can also suffocate if their faces, Infants can also suffocate if their faces, noses or mouths are covered by soft noses or mouths are covered by soft bedding, such as pillows, quilts, bedding, such as pillows, quilts, comforters and sheepskins.comforters and sheepskins.An overlay is a type of unintentional An overlay is a type of unintentional suffocation. This occurs when an infant is suffocation. This occurs when an infant is sleeping with one or more persons (bed sleeping with one or more persons (bed sharing) and someone rolls over on them. sharing) and someone rolls over on them.

Missouri Infant Deaths in Missouri Infant Deaths in 20072007

In 2007, there were 127 sudden, In 2007, there were 127 sudden, unexpected deaths of infants less than unexpected deaths of infants less than one year of age in Missouri, as reported one year of age in Missouri, as reported to the Missouri Child Fatality Review to the Missouri Child Fatality Review Program (CFRP). Program (CFRP).

Of those 127 sudden, unexpected deaths of Of those 127 sudden, unexpected deaths of infants under the age of one year, based on infants under the age of one year, based on autopsy, investigation and CFRP panel autopsy, investigation and CFRP panel review, 15 were diagnosed as Sudden Infant review, 15 were diagnosed as Sudden Infant Death Syndrome (SIDS), 59 Unintentional Death Syndrome (SIDS), 59 Unintentional Suffocation, 25 Illness / Natural Cause, and Suffocation, 25 Illness / Natural Cause, and 23 could not be determined (but had 23 could not be determined (but had questionable circumstances). Four infants questionable circumstances). Four infants were found to be victims of Homicide and were found to be victims of Homicide and one infant’s death was determined to be an one infant’s death was determined to be an Accident, resulting from exposure to Accident, resulting from exposure to excessive heat. excessive heat.

Sudden Unexpected Infant Sudden Unexpected Infant Deaths in Missouri (2007)Deaths in Missouri (2007)

The father of an 8-week-old infant put her The father of an 8-week-old infant put her down to sleep prone on a standard size down to sleep prone on a standard size pillow, in an adult bed. He later found her pillow, in an adult bed. He later found her unresponsive, after she had apparently slid unresponsive, after she had apparently slid off the pillow with her face down into the off the pillow with her face down into the bedding.bedding.

A child care provider placed a 10-week-old A child care provider placed a 10-week-old infant on his side in a playpen for a nap. A infant on his side in a playpen for a nap. A short time later, she found him lifeless on his short time later, she found him lifeless on his stomach with his face down.stomach with his face down.

A 6-week-old infant was sleeping in a full-A 6-week-old infant was sleeping in a full-size bed with his mother and two siblings, size bed with his mother and two siblings, ages 5 and 3. The mother was awakened ages 5 and 3. The mother was awakened by the 5-year-old telling the 3-year-old to by the 5-year-old telling the 3-year-old to get off the baby. The infant was get off the baby. The infant was unresponsive.unresponsive.A 3-month-old infant was placed on his A 3-month-old infant was placed on his stomach in a crib with bumper pads. He stomach in a crib with bumper pads. He scooted to the corner of the crib with his scooted to the corner of the crib with his face against the plastic bumper. This face against the plastic bumper. This created an environment in which he was created an environment in which he was re-breathing his own exhaled air, causing re-breathing his own exhaled air, causing him to suffocate.him to suffocate.

Safe Sleep EnvironmentsSafe Sleep EnvironmentsOne way parents can help to prevent SIDS One way parents can help to prevent SIDS is to provide a Safe Sleep Environment. is to provide a Safe Sleep Environment.

The American Academy of Pediatrics The American Academy of Pediatrics (AAP) does not recommend bed sharing (AAP) does not recommend bed sharing during sleep. The AAP recommends a during sleep. The AAP recommends a separate, but approximate, sleeping separate, but approximate, sleeping environment. There is growing evidence environment. There is growing evidence that room sharing (infant sleeping in a crib that room sharing (infant sleeping in a crib in parent’s bedroom) is associated with a in parent’s bedroom) is associated with a reduced risk of SIDS.reduced risk of SIDS.

The Center for Disease Control and The Center for Disease Control and Prevention recommends the following: Prevention recommends the following: Infants should ALWAYS be placed on Infants should ALWAYS be placed on

their backs (face up) when they are their backs (face up) when they are resting, sleeping or left alone. resting, sleeping or left alone.

Infants should be placed on their Infants should be placed on their tummies ONLY when they are awake tummies ONLY when they are awake and supervised by someone and supervised by someone responsible. Supervised tummy time responsible. Supervised tummy time is encouraged to help make an infant’s is encouraged to help make an infant’s neck and back muscles strong.neck and back muscles strong.

When infants are sleeping or When infants are sleeping or napping, they should only be placed napping, they should only be placed in cribs approved by the Consumer in cribs approved by the Consumer Product Safety Commission (CPSC). Product Safety Commission (CPSC).

If a crib is not available, an infant If a crib is not available, an infant should be placed on another safe, should be placed on another safe, firm sleep surface such as a firm sleep surface such as a bassinet or cradle that does not bassinet or cradle that does not have fluffy or soft items on its sleep have fluffy or soft items on its sleep surface.surface.

Infants should always be placed on Infants should always be placed on a firm surface or mattress. a firm surface or mattress.

Infants should be dressed in a Infants should be dressed in a sleeper or warm pajama instead of sleeper or warm pajama instead of covering the infant with a blanket. covering the infant with a blanket.

If an infant is covered with a If an infant is covered with a blanket, make sure the blanket stays blanket, make sure the blanket stays at or lower than the infant’s waist. at or lower than the infant’s waist.

Parents or caregivers who want to Parents or caregivers who want to be close to their infant while they be close to their infant while they are sleeping, can move the crib or are sleeping, can move the crib or bassinet next to their bed. bassinet next to their bed.

Infants should not be placed to Infants should not be placed to sleep on sofas, couches, pillows or sleep on sofas, couches, pillows or waterbeds. waterbeds.

Infants should not be placed to Infants should not be placed to sleep with stuffed toys, pillows, sleep with stuffed toys, pillows, bumper pads, quilts or comforters. bumper pads, quilts or comforters.

(Centers for Disease Control and Prevention)(Centers for Disease Control and Prevention)

Additional Safe Sleep Environment Tips Additional Safe Sleep Environment Tips from AAP: from AAP: Place the crib in an area that is always Place the crib in an area that is always

smoke free.smoke free. Avoid letting the baby get too hot. Dress Avoid letting the baby get too hot. Dress

the baby lightly for sleep and set the the baby lightly for sleep and set the room temperature in a range that is room temperature in a range that is comfortable for a lightly-clothed adult. comfortable for a lightly-clothed adult.

Breastfeed your baby. Experts Breastfeed your baby. Experts recommend that mothers feed their recommend that mothers feed their children human milk at least through the children human milk at least through the first year of life. first year of life.

BABIES SHOULDBABIES SHOULDBE PLACED ON BE PLACED ON THEIR BACKS TO THEIR BACKS TO SLEEPSLEEP

CRIBS SHOULDCRIBS SHOULDBE FREE OF BE FREE OF STUFFED STUFFED ANIMALS AND ANIMALS AND TOYSTOYS

BLANKETS SHOULDBLANKETS SHOULDBE AT OR LOWER BE AT OR LOWER THAN THE BABY’S THAN THE BABY’S WAISTWAIST

CRIBS SHOULDCRIBS SHOULDHAVE FIRMHAVE FIRMMATTRESSESMATTRESSES

BABY’S FACEBABY’S FACEAND HEAD AND HEAD SHOULD BESHOULD BEUNCOVEREDUNCOVERED

BABIES SHOULD BABIES SHOULD SLEEP IN A SLEEP IN A SMOKE FREESMOKE FREEENVIRONMENTENVIRONMENT

SAFE SLEEP ENVIRONMENTSAFE SLEEP ENVIRONMENT

Using Fans to Prevent SIDSUsing Fans to Prevent SIDS

In October 2008, a new study was In October 2008, a new study was released from released from Archives of Pediatrics & Archives of Pediatrics & Adolescent Medicine.Adolescent Medicine. The study The study included interviews with the mothers of included interviews with the mothers of 185 infants who died from SIDS and the 185 infants who died from SIDS and the mothers of 312 other babies. mothers of 312 other babies. According to the study, fans in a baby’s According to the study, fans in a baby’s room may help prevent SIDS. Fans room may help prevent SIDS. Fans offered even more protection to babies offered even more protection to babies sleeping in warm rooms. sleeping in warm rooms.

According to the study, babies who According to the study, babies who slept with a fan in their room reduced slept with a fan in their room reduced their chances of dying from SIDS by 72 their chances of dying from SIDS by 72 percent. percent.

Researchers think fans may help to Researchers think fans may help to circulate fresh air and prevent babies circulate fresh air and prevent babies from suffocating by re-breathing from suffocating by re-breathing exhaled carbon dioxide, one of the exhaled carbon dioxide, one of the culprits many doctors feel causes culprits many doctors feel causes SIDS.SIDS.

Safe Crib ProjectSafe Crib Project

The Safe Crib Project provides a new, safe The Safe Crib Project provides a new, safe crib to families in need, along with parent crib to families in need, along with parent education about safe sleep arrangements for education about safe sleep arrangements for infants. In communities throughout infants. In communities throughout Missouri, social service agencies, Missouri, social service agencies, community health agencies, hospitals and community health agencies, hospitals and other organizations have collaborated to other organizations have collaborated to implement the Safe Crib Project, using implement the Safe Crib Project, using funding from the Missouri Children’s Trust funding from the Missouri Children’s Trust Fund. Fund.

The goal of the Safe Crib Project is to The goal of the Safe Crib Project is to save infant lives and support families. save infant lives and support families. For more information about active Safe For more information about active Safe Crib Projects or funding opportunities, Crib Projects or funding opportunities, please contact the Children’s Trust please contact the Children’s Trust Fund at 573-751-5147 or visit Fund at 573-751-5147 or visit www.ctf4kids.orgwww.ctf4kids.org. .

For More Information, Visit For More Information, Visit These Websites:These Websites:

National SIDS/Infant Death Resource National SIDS/Infant Death Resource Center, Center, www.sidscenter.orgwww.sidscenter.orgNational Institute of Child Health and National Institute of Child Health and Human Development, Human Development, www.nichd.nih.gov/sids/sids.cfmwww.nichd.nih.gov/sids/sids.cfmSIDS Resources, Inc., SIDS Resources, Inc., www.sidsresources.orgwww.sidsresources.orgSt. Louis Safe Sleep Task Force,St. Louis Safe Sleep Task Force, www.stlsafesleepforbabies.com/www.stlsafesleepforbabies.com/

Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, www.cdc.gov/SIDS/sleepenvironment.htmwww.cdc.gov/SIDS/sleepenvironment.htmFirst Candle, First Candle, www.firstcandle.orgwww.firstcandle.orgAmerican Academy of Pediatrics (American Academy of Pediatrics (Healthy Healthy Child Care America Back to Sleep Child Care America Back to Sleep Campaign), Campaign), www.healthychildcare.orgwww.healthychildcare.orgAmerican Academy of Pediatrics, American Academy of Pediatrics, www.aappolicy.orgwww.aappolicy.orgMissouri Department of Health and Senior Missouri Department of Health and Senior Services, Services, http://www.dhss.mo.gov/SafeSleep/http://www.dhss.mo.gov/SafeSleep/

Missouri Department of Social Services Missouri Department of Social Services State Technical Assistance TeamState Technical Assistance Team

Address:Address: PO Box 208PO Box 208

Jefferson City, MO Jefferson City, MO 65102-020865102-0208

Telephone: Telephone: (573) 751-5980(573) 751-5980(800) 487-1626(800) 487-1626(8 a.m. to 5 p.m. CST, (8 a.m. to 5 p.m. CST, Monday – Friday) Monday – Friday)

Email:Email:    [email protected]@dss.mo.gov