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Source publication
The incidence of sudden infant death syndrome (SIDS) in the United States has decreased with decreased prone sleeping. Extrapolating from Census Bureau data, approximately 7% of SIDS should occur in organized child care settings (ie, child care centers or family child care homes). However, 2 states have reported higher rates of SIDS in child care....
Contexts in source publication
Context 1
... pro- portion of child care deaths did not increase during the survey, with 203 of 906 deaths (22.41%) in 1995, 130 of 692 (18.79%) in 1996, and 56 of 315 (17.78%) in 1997. The proportion of child care deaths in the in- dividual states ranged from 9.4% (Florida) to 40.2% (Minnesota; Table 2). Approximately 60% of SIDS in child care occurred in family child care homes ( Table 2). ...
Context 2
... proportion of child care deaths in the in- dividual states ranged from 9.4% (Florida) to 40.2% (Minnesota; Table 2). Approximately 60% of SIDS in child care occurred in family child care homes ( Table 2). The prevalence of prone as the usual sleep posi- tion was not increased in the child care cohort. ...
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Purpose:
Safe sleep practices (SSP) are among the main strategies to reduce sleep-related sudden unexplained infant death (SUID). Daycare personnel must be knowledgeable and trained in SSP related to SUID. This study explored the experience, knowledge, and confidence regarding SSP associated with SUID of daycare personnel.
Methods:
A cross-secti...
Citations
... Even though all states monitor safety at licensed child care programs, there are few large, systematic studies analyzing this inspection data. In the few studies that have looked into differences in rates of injuries and accidents in home-versus center-based care, researchers have found that in general, the small number of fatalities that do occur are more likely to occur in home-based settings, and researchers have documented significantly higher rates of violent deaths to infants and incidences of sudden infant death syndrome (SIDS) in home-based as compared to center-based settings (Moon et al., 2000;Wrigley & Dreby, 2005). Despite these differences, research finds that overwhelmingly, rates of unintentional injuries and fatalities in early learning settings are very low (with injury rates it's like, I'm coming home, it's not like, you know, going to school. ...
The number of family child care (FCC) providers in the United States, or providers who are licensed, certified, or registered to provide care in their home, fell by nearly half between 2005 and 2017 (NCEQA, 2020a). This has implications for families who prefer FCC settings. Understanding providers’ motivations for starting their program may provide policymakers with information on how to better support providers drawn to this setting. Through interviews with 30 Black/bi-racial FCC providers, we found providers started their programs to support family/neighbors, to provide an alternative perceived to be safer than center-based programs, and to be in charge. In terms of differences, providers felt they had more control and that they could provide more individualized attention in home-based settings as compared to center-based settings. This research advances the study of why providers work in home-based programs, and how they perceive this work as different from center-based care, with implications for supporting the FCC workforce.
... The serotonin system: Researchers have looked into genes connecting the serotonin system and SIDS cases, such as FEV (the human equivalent of Pet1), TPH2 (tryptophan hydroxylase, the rate-limiting enzyme for serotonin), and HTR1A and HTR2A (serotonin receptors). Until now, no rare or damaging variants have been reported among them [67]. SIDS sufferers exhibit dysregulated autonomic function and altered neurochemistry, reduced brainstem 5-HT (5-hydroxytryptamine), tryptophan hydroxylase-2 (TPH-2), and 5-HT receptor binding and receptor expression, thereby providing proof that serotonin plays a pivotal role in SIDS [23,[68][69][70]. ...
Sudden infant death syndrome (SIDS) continues to be one of the top causes of infant death in the U.S. Despite significant public health initiatives focused on high-risk populations to enhance sleep environments and techniques. The SIDS rate has remained stable in recent years. Risk factors and newer risk reduction strategies for SIDS are the focus of this review article. We conducted a comprehensive literature search on Medline, Cochrane, Embase, and Google Scholar until July 2022. The following search strings and Medical Subject Heading (MeSH) terms were used: "SIDS," "Sudden Infant Death" and "SUID". We explored the literature on SIDS for its epidemiology, pathophysiology, the role of various etiologies and their influence, associated complications leading to SIDS, and preventive and treatment modalities. Despite a more than 50% drop-in rates since the start of the "Back to Sleep" campaign in 1994, sudden infant death syndrome (SIDS) continues to be the top cause of post-neonatal mortality in the United States, despite continued educational initiatives that support safe sleep and other risk reduction strategies. The new American Academy of Pediatrics guidelines for lowering the risk of SIDS include a lot of emphasis on sleeping habits, bedding, and environment but also include elements that are frequently ignored (i.e., prenatal care, smoking, alcohol and drug use, and childhood vaccinations). This study highlights these less-frequently discussed aspects and identifies treatments that have produced beneficial behavioral shifts that benefit newborns as well as their mothers' health and wellbeing.
... Se ha demostrado que el riesgo del sueño en prono (OR: 2,6 95% IC 1,5-4,5) y en posición lateral (OR: 2,0 95% IC 1,2-3,4) para el desarrollo de muerte súbita son similares, lo que se explica por la inestabilidad de la posición lateral que implica una alta probabilidad de girar hacia la posición prono 17 . Se ha descrito una mayor probabilidad de ubicar al lactante en posición en prono o decúbito lateral en cuidadores nuevos, así como en las guarderías donde tienden de cambiar de posición a lactantes habituados al sueño en supino 18 . Algunos padres han mostrado preocupación por el posible riesgo de asfixia cuando el lactante duerme en posición supina. ...
La muerte súbita e inesperada en la infancia (MSII) definida como la muerte de un menor de 1 año durante el sueño sin motivo evidente de manera inicial, sigue siendo una de las causas más frecuentes de mortalidad infantil tardía. Aproximadamente 3.500 lactantes mueren anualmente en Estados Unidos por muertes relacionadas con el sueño. Se postula un origen complejo y multifactorial en un lactante vulnerable, sin embargo, su fisiopatología no se ha logrado comprender por completo. Los profesionales de la salud juegan un rol clave en la promoción de las medidas preventivas descritas en la literatura que incluyen dormir en posición supina sobre una superficie firme, evitar el tabaquismo y el colecho, promover la lactancia materna, entre otros. El objetivo de esta revisión es resumir las principales características epidemiológicas y fisiopatológicas de la MSII y factores relacionados con el sueño seguro.
... [151][152][153] Despite the evidence against aspiration in the supine position, many parents and caregivers remain unconvinced. [154][155][156][157][158][159][160][161][162] Coughing or gagging is misconstrued as aspiration, although it represents the normal protective gag reflex. The AAP concurs with the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition that the risk of SUID outweighs the benefit of prone or lateral sleep position on GER. ...
Of the nearly 3.8 million infants born in the United States in 2018, 8.3% had low birth weight (<2500 g [5.5 lb]) and 10% were born preterm (gestational age of <37 completed weeks). Many of these infants and others with congenital anomalies, perinatally acquired infections, and other disease require admission to a NICU. In the past decade, admission rates to NICUs have been increasing; it is estimated that between 10% and 15% of infants will spend time in a NICU, representing approximately 500 000 neonates annually. Approximately 3600 infants die annually in the United States from sleep-related deaths, including sudden infant death syndrome International Classification of Diseases, 10th Revision (R95), ill-defined deaths (R99), and accidental suffocation and strangulation in bed (W75). Preterm and low birth weight infants are particularly vulnerable, with an incidence of death 2 to 3 times greater than healthy term infants. Thus, it is important for health care professionals to prepare families to maintain their infant in a safe sleep environment, as per the recommendations of the American Academy of Pediatrics. However, infants in the NICU setting commonly require care that is inconsistent with infant sleep safety recommendations. The conflicting needs of the NICU infant with the necessity to provide a safe sleep environment before hospital discharge can create confusion for providers and distress for families. This technical report is intended to assist in the establishment of appropriate NICU protocols to achieve a consistent approach to transitioning NICU infants to a safe sleep environment as soon as medically possible, well before hospital discharge.
... Paid family leave can be argued to be lifesaving during infancy, since about 3500 infants die in their sleep every year from accidental suffocation or unknown causes, known as sudden infant deaths or SIDs (Sole-Smith, 2016). Research appears to suggest that infants are better off when they are taken care of by a parent rather than by a child care provider, since there is a correlation between infants placed in child care and SIDs (Moon, Patel, & McDermott-Shaefer, 2000;Moon, Sprague, & Patel, 2005;Sole-Smith, 2016). Approximately one-third of SIDs-related deaths occur in the first week that an infant spends time in child care, with half of the deaths occurring on the first day (Sole- Smith, 2016). ...
During the past four decades, most OECD (Organisation for Economic Co-operation and Development) countries have adopted or expanded paid family leave, which offers leave to workers following the birth or adoption of a child as well as care for ill family members. While the effects of paid maternity leave on child health have been the subject of a large body of research, little is known about fathers’ leave-taking and the effects of paid paternity leave. This is a limitation, since most of the recent expansion in paid family leave in OECD countries has been to expand leave benefits to fathers. Mothers’ and fathers’ leave-taking may improve child health by decreasing postpartum depression among mothers, improving maternal mental health, increasing the time spent with a child, and increasing the likelihood of child medical checkup. The purpose of this paper is to examine the effects of paid family leave on the wellbeing of children, extending what we know about the effects of maternity leave and establishing new evidence on paternity leave. The paper examines the effects of paid family leave expansions on country-level neonatal mortality rates, infant mortality rates, under-five mortality rates, and the measles immunization rates in 35 OECD countries, during the time period of 1990 to 2016. Using an event study design, an approximately 1.9 to 5.2 percent decrease in the infant, neonatal, and under-five mortality rates has been found following the adoption of paid maternity leave. However, the beneficial impact is not as visible for extension of paid leave to fathers. The implications and potential reasons behind the larger protective effects of maternity leave over paternity leave on child health outcomes are discussed.
... This fact is justified by the high prevalence of the phenomenon in child care settings, as indicated in the study (20) , which reports 20% of sudden infant death syndrome during sleep in child care settings. A study conducted in the United States, investigating 1,916 cases of sudden infant death syndrome, found that 20.4% of these deaths occurred in child care settings (21) . Therefore, the risk of sudden infant death syndrome is extremely high during sleep in daycare settings (22) . ...
Objective:
To identify evidence available in the literature about sleep patterns of infants attending nurseries.
Method:
An integrative review of studies published in Portuguese, English or Spanish available in full text on LILACS, CINAHL, and PubMed databases. The following descriptors sono, lactente and creches or berçários (in Portuguese) and sleep, infant and childcare or nurseries were used for LILACS, CINAHL and Pubmed, respectively. Nine studies were selected and analyzed.
Results:
The main component explored in the studies about sleep pattern is the sleep position of the infants, due to its association with sudden infant death syndrome. The results pointed to the need to promote and develop written guidelines regarding behavioral practices to reduce the risk of this phenomenon.
Conclusion:
Evidence has identified sleep issues, mainly regarding the sleep position of the infant and the environment where the infant sleeps, showing that it is critical to set routines and interventions to improve the quality of sleep care of infants attending nurseries.
... The probability of the occurrence of the apnea episodes tends to decrease with 36 to 37 weeks of gestational age. Among the main risk factors involved in the AOP include multiple pregnancies, sex, and race of the infants and metabolic diseases such as maternal diabetes [10,11]. General classification of apnea includes central sleep apnea (CSA), obstructive sleep apnea syndrome (OSAS) and mixed sleep apnea (MA). ...
Apnea in the paediatric population is associated with increased morbidity and mortality in a large number of developed as well as developing countries. It is even more prominent in preterm newborn infants and is commonly referred to as apnea of prematurity. Its current diagnosis and therapy involve the use of traditional technologies which often result in discomfort to the infants due to the use of invasive devices attached to their sensitive skin, especially in overnight clinical sleep analysis (for over 12- or 24-hour period). Emerging trends for the point-of-care diagnosis of this sleep disorder are focused on the design of integrated devices for less complex and non-invasive monitoring. This paper presents a review of the state-of-art of clinical technologies and methodologies for sleep apnea detection and their pros and cons, with particular focus on their working principles and relevance to paediatrics. Moreover, an in-depth discussion on emerging future technologies envisioned to be integral parts of the daily home-based applications is included in the paper.
... Most of the data available about out-of-home infant deaths are for those that have occurred in child care settings. 4,5 Infants dying in child care were more likely to die during the first week of child care and were more likely to be last placed or found prone, when the usual sleep position is nonprone. 4 One additional study with data about out-of-home deaths is a case-control study from Germany, which found that the risk of SIDS was higher when the infant slept at a relative's home compared with the parental home, although no analysis of risk factors by setting was conducted. ...
... 4,5 Infants dying in child care were more likely to die during the first week of child care and were more likely to be last placed or found prone, when the usual sleep position is nonprone. 4 One additional study with data about out-of-home deaths is a case-control study from Germany, which found that the risk of SIDS was higher when the infant slept at a relative's home compared with the parental home, although no analysis of risk factors by setting was conducted. 6 In this study, we sought to identify risk factors for sleep-related infant death occurring in a broad range of settings outside of the parental home. ...
... Studies of sleep practices in child care settings have found that many child care providers place infants prone for sleep. 4,5,12 Although public health campaigns targeting parents and primary caregivers in the home setting and at licensed child care settings improve knowledge about safe sleep practices 13,14 and have resulted in a significant decline in the risk of sleep-related deaths among infants, 15 the findings of this study suggest continued gaps in practices to prevent sleep-related infant deaths, particularly in outof-home settings and in settings with nonparental caregivers. Unfortunately, for many parents who need to re-enter the work force after the birth of a child, the care of infants outside of the home is not a choice, but an unavoidable economic necessity. ...
Background and objective:
Multiple environmental risk factors are associated with sleep-related infant deaths. Little is known about differences in risk factors for deaths occurring in-home and out-of-home. We sought to compare risk factors for in-home and out-of-home infant deaths.
Methods:
We conducted a cross-sectional analysis of sleep-related infant deaths from 2004 to 2014 in the National Child Fatality Review and Prevention database. The main exposure was setting (in-home versus out-of-home) at time of death. Primary outcomes were known risk factors: sleep position, sleep location (eg, crib), objects in the environment, and bed sharing. Risk factors for in-home versus out-of-home deaths were compared using the χ(2) test and multivariate logistic regressions.
Results:
A total of 11 717 deaths were analyzed. Infants who died out-of-home were more likely to be in a stroller/car seat (adjusted odds ratio, 2.6; 95% confidence interval, 2.1-3.4; P < .001) and other locations (adjusted odds ratio, 1.9; 95% confidence interval, 1.5-2.3; P < .001), and placed prone (adjusted odds ratio, 1.1; 95% confidence interval, 1.02-1.27; P = .02). Bed sharing was less common out-of-home (adjusted odds ratio, 0.7; 95% confidence interval, 0.6-0.7; P < .001). There were no differences in sleeping in an adult bed/on person, on a couch/ chair, or objects in the sleep environment.
Conclusions:
Sleep-related infant deaths in the out-of-home setting have higher odds of having certain risk factors, such as prone placement for sleep and location in a stroller/car seat, rather than in a crib/bassinet. Caregivers should be educated on the importance of placing infants to sleep supine in cribs/bassinets to protect against sleep-related deaths, both in and out of the home.
... Some of these risk factors can be modified, giving a baby the best chance for survival. [14] ...
Sudden infant death syndrome (SIDS) has been the focus of extensive research over the past several decades. Sudden infant deaths in infancy (SID) represent the commonest group of post-neonatal childhood deaths. The identification of specific medical causes of death at autopsy in SID has slightly improved in recent years, but around two-thirds of cases remain unexplained, being classified as SIDS, the diagnosis is based on a a thorough death scene investigation, autopsy, review of infant's and family's medical records and histories. The aim of this article is to review the current evidence for protocols of post-mortem investigations of SID, with particular emphasis on features which include characteristics, reporting causes, prevention, diagnosis and how to reduce the risk factors. The article will not discuss issues related to non-accidental or inflicted injury, which remain complex and beyond the scope of this review.
... Most safe infant sleep legislation and regulation have focused on child care professionals. Approximately 20% of SIDS deaths in the U.S. occur in child care settings [62,63], and unaccustomed prone positioning has been associated with these deaths [62]. After studies in the 1990's demonstrated that 75% of child care providers were placing infants prone for sleep [64,65], many states began implementing child care regulations regarding infant sleep position, infant sleep location, use of bedding, and prohibition of smoking [66]. ...
... Most safe infant sleep legislation and regulation have focused on child care professionals. Approximately 20% of SIDS deaths in the U.S. occur in child care settings [62,63], and unaccustomed prone positioning has been associated with these deaths [62]. After studies in the 1990's demonstrated that 75% of child care providers were placing infants prone for sleep [64,65], many states began implementing child care regulations regarding infant sleep position, infant sleep location, use of bedding, and prohibition of smoking [66]. ...
Sudden infant death syndrome (SIDS) and other sleep-related infant deaths, such as accidental suffocation and strangulation in bed and ill-defined deaths, account for >4000 deaths annually in the USA. Evidence-based recommendations for reducing the risk of sleep-related deaths have been published, but some caregivers resist adoption of these recommendations. Multiple interventions to change infant sleep-related practices of parents and professionals have been implemented. In this review, we will discuss illustrative examples of safe infant sleep interventions and evidence of their effectiveness. Facilitators of and barriers to change, as well as the limitations of the data currently available for these interventions, will be considered.
