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

Summary: Raleigh News & Observer Articles

From February 16-18, 2003 the Raleigh News & Observer published a three part series entitled Case Closed: Death in Day Care.

The investigative reporting showed that 33 children died in NC child care over the past four years, an average of one death every six weeks. Eighteen of the deaths were diagnosed as SIDS and the others were accidental or attributed to natural causes. The series called into question the lack of a statewide policy mandating safe sleep positioning to reduce SIDS risk, the oversight of providers when licensing violations occur and poor coordination of investigations of abuse and neglect in child care.

The first article in the series "The Day Drew Died" featured Tammy Jones and Drew, her 8-week-old son. Drew died suddenly and unexpectedly on his very first day in a Statesville family child care home. The N&O reported that "more than half of the child deaths in NC day cares over the past four years were attributed to Sudden Infant Death Syndrome. Of those 18 deaths, seven babies were known to have been on their stomachs; three were known to have been put to sleep on their backs."

Articles on day two, including "Kaitlyn's Legacy" revolved around the operation of unlicensed child care. "Five-month-old Kaitlyn Shevlin died while napping in a bouncy seat, a bottle of milk propped at her side, in an unlicensed day-care home ..." The unauthorized administration of a medication known to cause drowsiness, to Kaitlyn clouded the circumstances in which she died in this Alamance County family child care home.

On day three, the article "Red Flags Ignored" addressed the investigation of abuse or neglect complaints and circumstances after a child dies in child care. The authors concluded that child care investigations were poorly coordinated between the child care investigators, Department of Social Services, law enforcement and medical examiners.

As strongly worded editorial, "A Cradle Will Fall" on Wednesday Feb. 19 emphasized no tolerance of illegal, unlicensed day cares; the need for a state law requiring back to sleep practices for babies in child care; strengthening criminal and civil penalties for violating current child care regulations and improved coordination of child care investigations.

NC Legislation in Child Care Proposed

On February 27, 2003, Rep. Martha Alexander (D) from Mecklenburg County introduced a bill to address issues highlighted in the N&O.

House Bill 152 whose short title is "Unauthorized Meds./Prevent SIDS/Child Care" is designed to:

• Require child care facilities to place children in a sleeping position that reduces the risk of SIDS;
• Prohibit the administration of medication to a child in a licensed or unlicensed child care without proper authorization from the child's parent or guardian;
• Require certain agencies and the medical community to cooperate in investigating reports of child abuse and neglect in child care facilities.

House Bill 152 was discussed by the Children, Youth and Families Committee on March 26, April 2, and April 9. Information was provided to committee members by the N.C. Healthy Start Foundation, the ITS-SIDS Project, DCD, the N.C. Pediatric Society, the N.C. Child Care Coalition and others. If passed this session, the act would become effective December 1, 2003.

On January 28, a legislative briefing was held in Washington, DC to kick off a national initiative that promotes strategies to lower SIDS risks in child care settings. Janice Freedman, Executive Director the N.C. Healthy Start Foundation, was there to advocate for the health and safety of children and to meet with elected officials. She received strong support from the N.C. delegation members that she visited: Senators Edwards and Dole, Representatives Price, Etheridge, and Miller.

The national initiative builds on the success of the "Healthy Child Care America" and "Back to Sleep" campaigns to unite child-care, health, and SIDS prevention partners across the country to reduce the number of SIDS-related deaths in child care settings. To learn more about this new initiative, go to http://www.aap.org/advocacy/hcca/backtosleep/index.htm.

The ITS-SIDS Project was one of three projects featured in a follow-up national teleconference on March 24 as part of this initiative. The teleconference also featured Train-The-Trainer Projects in New York and the First Candle/SIDS Alliance designed to reduce SIDS in child care settings. Pediatrician and SIDS researcher, Dr. Rachel Moon facilitated the teleconference.

A second teleconference focusing on safe sleep legislation is scheduled for June 2, 2003 at 12:30-1:30 PM EST. For registration information, contact Lauren Kotch at the American Academy of Pediatrics via email: LKotch@aap.org.

Sponsors of the new Healthy Child Care America Back to Sleep Campaign include the US Department of Health and Human Services, Child Care Bureau and Maternal and Child Health Bureau; the American Academy of Pediatrics; First Candle/SIDS Alliance; and the CJ Foundation for SIDS.

The ITS-SIDS Project is moving right along!

• The ITS-SIDS Training Manual were completed and Toolkit packets were assembled.
• A series of five ITS-SIDS Train-The-Trainer sessions were conducted from February 19 to Feb 26 for counties with the highest SIDS rates.
• Sixty-four trainers received ITS-SIDS training, representing 39 counties.
• Participants received the ITS-SIDS Training Manual and 4 sets of Toolkits containing resource materials for 100 child care providers.
• The ITS-SIDS Training was certified by the NC Nurses Association for two years.
• 22 registered nurses received 4.8 contact hour nursing credits for their ITS-SIDS training.
• As of April 14, 60% of the certified trainers have scheduled ITS-SIDS trainings for child care providers.
• A total of 70 trainings have been scheduled.
• Approximately 345 child care providers have received training.
• The Division of Child Development is working with the ITS-SIDS Project to streamline the ITS-SIDS training authorization process.
  

Click here to access the ITS-SIDS Training Schedule for child care providers.

An on-line discussion forum for those trained is being developed. The ITS-SIDS electronic Network/Information Exchange for Trainers (ITS-SIDS eNET) is scheduled to go on-line in May. ITS-SIDS Trainers will be contacted when they will be able to access the discussion forum.