ITS-SIDS For Childcare Providers When SIDS happens

Overview

No one wants SIDS to happen. But the sad reality is that SIDS sometimes does occur in child care despite providers' best efforts to keep children safe. Until the exact causes of SIDS are known SIDS is not preventable but the best any provider can do is to try and reduce the risks.

The single most important step childcare providers can take is to have healthy babies sleep on their backs as is now required by N.C. law and licensing rules. Talking with the babies' doctors can helps determine the safest sleep position for a baby with a medical condition. Make sure cribs are safe and keep toys, pillows, bumper pads and extra blankets out of the cribs while babies sleep. Ensure babies don't get too hot and aren't dressed too warmly. Keep the room where babies sleep in the safe range of 68-75°F. Keep tobacco smoke away from babies. Follow these safety guidelines to create safer child care and lessen the chances of SIDS.

What Can a Provider Expect?

It is an emergency situation when a child is found unresponsive in a child care! Every effort must be made to revive the child, get emergency medical help and inform the parents immediately.

Providers must ensure that the other children in the family home or center are cared for during this emergency. You should contact your emergency back-up. A staff member, most likely the director or owner, should accompany the unresponsive infant to the hospital. Remember to bring the child's parent contact information with you.

If the child dies, providers should know that it takes time to determine the actual cause of death and that an investigation is required. It will be necessary to talk with the first responders, whether they are the EMT or the police, with the hospital emergency staff and with the parents. Parents may respond angrily as they try to make sense of this tragedy. This is an emotionally intense time and you may experience shock, disbelief and anger.

What Happens During the Investigation?

Be prepared to talk with the police at length as they investigate the place where the baby died and try to understand what has happened. The police will ask questions about the events leading up to your discovery that the child was not responsive. They will want to know exactly how you responded. They will ask about your procedures, your staff, your facility. They may ask you what you know about the baby's health history. Answer all questions as completely as you can.

Other than trying to revive the baby it is important not to disturb the death scene afterwards. Do not clean and tidy the area or move furniture. As part of the process of trying to determine the cause of death, the police will need to take photographs and map out diagrams. They will likely take the baby's bedding, the last bottle the baby used, food samples from the baby's last meal, medicine or other items such as toys or clothing that came in contact with the baby.

In the event that a child dies while in your care, the N.C. Division of Child Development requires that childcare providers contact them within 24 hours of the child's death or the next working day in keeping with General Statute 110-102.

The DCD will conduct its own investigation, possibly in combination with the Department of Social Services, any time a child dies in a child care facility. One part of the investigation is to assess if any licensing violations contributed to the death. Contact your insurance company and follow their procedures.

It is not uncommon that reporters and other media respond to situations where a child has died in child care.

Inform Others

Others associated with your childcare facility will need to be informed about the situation. They too may also grieve the loss of the baby. Be prepared to talk with your staff and with the parents of the other children enrolled in your childcare center or home. Depending on the situation, the other children you care for may need some help understanding the emergency they witnessed and will want to know what happened to the baby.

It is important to remember that it will take time for the child's autopsy results to be completed, for the review of his or her medical history to be done, or for the death scene investigation to be finished before a final cause of death is identified. These steps can take several weeks or months before a SIDS diagnosis is determined as the cause of death by the medical examiner.

How Can Providers Face the Parents?

Although this is probably one of the hardest moments a provider has ever faced, maintaining contact with the parents is important for the grieving process. Remember, both of you are working through the tragedy of loosing this child. Parents want and need to understand what happened. They, like you, need reassurance that you did everything you could to keep their child safe. Caring and communicating are essential steps to try and make sense of the loss of a child and are important for your healing process.

Where Can a Provider Go for Help?

Call on close friends and family for support as you work through the worry and emotion you are experiencing. Your minister and religious community may also be a source of support during this difficult time. Consider grief counseling to help you, members of your own family and your staff.

Other childcare service agencies with whom you have a working relationship may be able to assist you and the family whose child has died. Contact your child care health consultant or your infant/toddler specialist.

SIDS Counselors at your county health department are trained to assist you and the child's parents with grief counseling. They can also help increase your understanding of SIDS. They can help you or the parents get additional counseling, if desired. SIDS counselors or the baby's doctor can help parents understand the autopsy report. There is no fee for SIDS Counselors' services.

Should Providers Continue Caring for Children?

Childcare providers who have experienced the death of a child while in their care are faced with difficult decisions about whether or not to continue providing child care. This is a personal choice and a decision in which your family should be involved.

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Last updated: November 2011