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

Sadly, the number of SIDS deaths for the Tarheel state rose in 2003 compared to the year before. Statewide, 100 infants died of SIDS, a 23% increase from the 81 sudden and unexpected infant deaths reported for 2002. North Carolina's SIDS rate for 2003 is 8.5 per 10,000 live births.

The 2003 SIDS data shows:

• AGE - 96% of SIDS deaths occurred within the first 6 months of life
• GENDER - More males (61%) than females (39%) died of SIDS
• RACE - 52% White; 42% Black, 4% American Indian, 2% Other
• HISPANIC ETHNICITY - 9%
• SEASON - Autumn 29%, Spring 28%, Summer 24%, Winter 19%

We do not know the reason for this increase in SIDS deaths. From year to year, we might expect to see some variation in the SIDS rate, which is why we look at the five-year trend for a more comprehensive understanding of SIDS over time. The five-year rate of .8 per 1,000 live births from 1999-2003 remained the same compared to 1998-2002. Still, the increase for 2003 is a grim reminder that we must do more to help reduce SIDS risks in families and strengthens our resolve to do so.

Thankfully, in 2003 there was a sharp decline in the number of total childcare deaths and the proportion of SIDS deaths in childcare. Four child deaths were reported compared to ten deaths in 2002. SIDS accounted for two of the deaths in 2003 and the other two were related to medical conditions including a congenital illness and Retro Syncytial Virus (RSV). The SIDS deaths occurred in family childcare homes and the other two child deaths happened in centers, one of which was an illegal facility.

The ITS-SIDS Project is committed to helping childcare providers lower SIDS risks for the infants in their care and to making bereavement resources available when SIDS does happen.

To view easy to read charts and tables about North Carolina's child deaths, including SIDS, in 2003 click on the link below: http://www.schs.state.nc.us/SCHS/deaths/child/CFinNC2003.pdf

For a county listing of infant and child deaths for North Carolina in 2003 click on the following link: http://www.schs.state.nc.us/SCHS/deaths/child/CFbyCO2003.pdf

In 2003, one of the deaths in child care was caused by the Retro Syncytial Virus or RSV. RSV is a leading cause of respiratory infections among infants and toddlers and is common in adults. It affects both the upper and lower respiratory tracts and is highly contagious.

Providers and parents can help protect infants from RSV by:

• washing their hands to help minimize the spread of the disease
• limiting baby's contact with others who have colds or the sniffles
• not exposing the baby to secondhand smoke

Premature infants (born at 35 weeks or less) whose lungs were under-developed at birth, are especially vulnerable to Retro Syncytial Virus. To learn more about who is at risk for RSV, signs and symptoms, how to prevent it and access to resources, click here: http://www.rsvprotection.com/

Q: How often should we check sleeping infants? What should we document?

A: Licensing rules require that sleeping infants must be visually checked and documentation of this process kept for 30 days. This rule allows the provider to determine how often and who does the checking. A statement about the conditions for visually checking sleeping infants should be included in the facility's Safe Sleep Policy. The National Association for the Education of Young Children (NAEYC) requires NAECY certified providers to check sleeping infants every five minutes. A reasonable rule of thumb for checking is every 15-20 minutes, although providers may decide to check more frequently. A sample Sleep Chart is available at www.nchealthystart.org_its-sids_sleepchart additional samples will be available on this Web site soon.

Q: Is there a specific date or deadline by when childcare providers must receive the ITS-SIDS training?

A: All childcare providers licensed to care for children ages 12 months or younger are required to receive the ITS-SIDS training within 4 months of when the rules went into effect (May 1, 2004) or within 4 months of hire, whichever is later. Thus, existing providers should have received training by the end of September unless they were newly hired. This includes owners, operators, directors, lead infant teachers, volunteers and others counted in the child-to-staff ratio.

Licensing consultants will be checking for compliance with the rules in the coming months. For a synopsis of the rules, click here: http://www.nchealthystart.org/downloads2/Safe_Sleep_Rules.pdf

To view a summary of the actual childcare licensing rules click here: http://www.nchealthystart.org/downloads2/NC_Lic_Rules_Sum.pdf

Legacy Policy Report - A report by the Legacy Foundation released in June 2004 documents the health and economic effects of secondhand smoke on children. The Legacy Policy Report is entitled "Secondhand Smoke Tearing Families Apart: The Health and Economic Burden of Smoking on Children." It discusses the link between smoking and SIDS, stating that in 2001 tobacco use accounted for more than 263 cases of SIDS and 26,000 low birthweight births. Nationally, exposure to tobacco smoke was attributable to 12% of SIDS deaths. To learn more click on the following link: http://ash.org/secondhandsmoke&kids.pdf

The National SIDS/Infant Death Resource Center has the following SIDS recent publications available. To access them, click on the web links below.
For a publication order form, go to: http://www.sidscenter.org/SIDSPubList.HTM

• "SIDS Deaths By Race And Ethnicity" http://www.sidscenter.org/Downloads/S148.htm
• "El Dolor de los Padres: Un Proceso de por Vida" - Spanish language version of "The Death of a Child, the Grief of the Parents: A Lifetime Journey," http://www.sidscenter.org/Downloads/S150.pdf

CONGRATULATIONS TRAINERS! The number of childcare providers you have trained has exceeded the three-year goal of 14,500 by 8,496 in just two years! Thank you for your hard work and dedication!

Although so many providers are now ITS-SIDS certified, many more caregivers require the ITS-SIDS training because of staff turnover, new hires and the more than anticipated numbers of providers wanting to be trained. The evaluations have been very positive and childcare providers say they would recommend the ITS-SIDS training to others.

Please continue to make your ITS-SIDS training available on a quarterly basis to help providers meet their licensing requirements.

To-date

As of September 30, 2004 a total of 22,996 childcare providers have been trained and 1,223 trainings have been scheduled or completed since the train-the-trainer sessions began in February 2003!

• Phase 1 - 10,136 childcare providers; 520 trainings scheduled or completed (18 months)
• Phase 2 - 9,398 childcare providers; 492 trainings scheduled or completed (10 months)
• Phase 3 - 3,462 childcare providers; 211 trainings scheduled or completed (5 months)
  

From July 2003 through June 2004, there were 304,400 SIDS-related materials distributed to childcare providers, parents, hospitals, health departments, social service professionals and others; 676 N.C. childcare-related organizations ordered 269,869 SIDS materials.

Staff Changes at ITS-SIDS

On August 18, we bid goodbye to Lisa Darnell, the ITS-SIDS project assistant, who joined us in 2002. Lisa, a student at N.C. State, had an opportunity to work with
a co-op program in her field of chemical engineering. We wish Lisa the best and thank her for her wonderful service!

Welcome to Melissa Draper as our new project assistant who came aboard on September 22. Melissa is majoring in Sociology at N.C. State and is a former reporter. She's a great addition to the project!

Trainer Recruitment

We are currently recruiting trainers for Phase 3B.

A new series of ITS-SIDS Train-the-Trainer sessions are scheduled for the week of December 6th. The training sites are Statesville, Greenville and Raleigh.

High priority counties include: Alleghany, Bladen, Cabarrus, Camden, Caswell, Davie, Franklin, Henderson, Hyde, Martin, Tyrell, Mecklenburg, Wilson, Wake.

Interested applicants from EXEMPT agencies should send an email to its-sids@NCHealthyStart.org and write "ITS-SIDS Training Phase 3B" in the subject line.

1. In November, we will be shipping to you a sample of two new mini-posters entitled Safe Sleep Rules for Caregivers in English and in Spanish as well as a CD of the 4th edition of the ITS-SIDS Training Manual.

2. Date Change - all rosters and evaluations should continue to be sent to the ITS-SIDS Project through August 2005.