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.

1. Infant Sleep Safety
Understanding Risks and
Exploring Safety Measures

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. Sudden Infant Death

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. What is SIDS?
SIDS is a diagnosis of exclusion, assigned only
once all known and possible causes of death
have been ruled out

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. 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. 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. 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. 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. Risk is highest in the infant’s first six
months of life. 2-4 months is the most
vulnerable time.

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. 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. Most babies encounter and survive
environmental stressors, e.g. second-hand
smoke, overheating, a stomach sleep
position, or upper-respiratory infection.

15. However, an already-vulnerable infant may
not be able to overcome them.

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. 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. SUIDSudden Unexpected Infant Death
SIDS
SIDS deaths are one
kind of SUID death

19. SUIDSudden Unexpected Infant Death
SIDS suffocation
asphyxiation
unexplainedOther deaths are on
the rise

20. Sleep Position
Risk Factors

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. 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. 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. 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. What You Can Do to Keep Infants as
Safe as Possible

26. What is “Safe to Sleep”?

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. BACK SLEEPING
Infants should be placed for sleep on
their back for EVERY SLEEP!!

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. 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. 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. 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. 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. 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. 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. 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. 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. PROVIDE SUPERVISED, AWAKE
TUMMY TIME
This helps facilitate development and minimize the
possibility of positional plagiocephaly

39. What You Can Teach Parents about
Risk Reduction

40. ROOM SHARING, NOT BED
SHARING
Evidence is mounting
that bed sharing
significantly increases
the risk of sudden
infant death.

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. 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. REGULAR PRENATAL CARE
There is evidence linking a lower risk of SIDS for infants whose
mothers obtain regular prenatal care.

44. AVOID
SMOKING, ALCOHOL, AND ILLICIT DRUG USE
DURING PREGNANCY AND AFTER BIRTH

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. 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. Remember:
Both maternal smoking during pregnancy and
smoke in the infant’s environment after birth are
major risk factors for SIDS.

48. BREAST FEEDING IS
RECOMMENDED
Breast feeding is associated with a reduced risk of
SIDS.

49. IMMUNIZATIONS
Infants should be immunized in accordance with
recommendations from the AAP and Centers for Disease
Control and Prevention.

50. Name the Risks in this Picture!

51. A Model of Safe Sleep
What do you notice?

52. Child’s Grief

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. 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. 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. 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. 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. 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. 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. What to do if the unimaginable
happens?

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. 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. Questions or Comments?

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. Resources
American Academy of Pediatrics
Dedicated to the Health of all
Children - www.aap.org

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. 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/