SIDS Risks in Child Care

Get your caregiver on board to keep your baby safe during sleep.

SIDS Risks in Child Care

There are a lot of things that parents worry about--and much of it unfounded. But our fears about SIDS are real and they’re warranted--it’s the one monster that we can’t shake. Sudden infant death syndrome, the death of a baby under the age of 1 that cannot be explained even after thorough investigation, remains the leading cause of death among U.S. infants. There are an estimated 1,500 cases each year , and one in five of these deaths happens during child care.

So while you may have studied the ins and outs of safe sleep , does your child-care provider know exactly what’s safe when it comes to your baby’s slumber?

To mark SIDS Awareness Month , we asked First Candle CEO Christopher Blake to help us keep our babies safe when we are not around.

1. Know the basics of safe sleep. Though research indicates that brain abnormalities linked to breathing and sleep arousal may play a role in SIDS, we still don’t fully understand why some infants are more vulnerable than others. But there are steps that you and your caregiver can take to protect your baby during sleep. According to the American Academy of Pediatrics you should always put your baby down to sleep on his back. You can share a room with him, but you should never share a bed. Fitted sheet aside, the crib should be bare: no plush toys, no blankets, no bumpers; and the mattress should be firm and tightly fitted to the crib. Dress your baby as you would with an extra layer, and do not cover his head to avoid overheating. Keep his room well ventilated and at a comfortable temperature (from 68 to 72 degrees). And no smoking around him. For more guidelines and to test your knowledge on sleep safety, go here .

2. Make sure your caretaker knows the guidelines too. The Safe to Sleep campaign has been educating parents and caregivers on safe sleep practices for years, and, as a result, has helped lower SIDS rates by more than half since the 1990s. That being said, crib deaths happen at a much higher rate when a child goes from home to child care . Many of these deaths are linked to unaccustomed tummy sleeping (being placed on the tummy when it isn’t the usual sleeping position), which could indicate that not all caregivers (relatives, nannies or daycare teachers) know how to promote a safe sleep environment.

Whether you are in the process of choosing a new child-care arrangement or already have one, arm yourself with the right questions:

-What’s the teacher to children ratio? The smaller, the better.

-Do they place any items in the cribs? Unequivocally, the answer should be, “no.”

-What is their safe sleep policy? This will tell you whether they are up to date with AAP recommendations.

-And do they have CPR and first aid training?

3. Speak up. “A lot of the times, parents think doctors or daycare providers are the professionals; that whatever they say goes,” Blake says. But when it comes to your child, you are the expert! So talk about SIDS and what you’ve done to keep it at bay. Give them a guide to your bedtime routine (like this one ) and ask that they follow it. “Parents need to be the ones who are empowered and to impart their knowledge on caregivers and relatives,” Blake says. “They need to be informed, know what they want and demand it.” If you have concerns, talk about them and make surprise visits to check on your child. Ultimately, you need to trust your instinct: if you are unsure of the care your baby is receiving, find another provider whom will match your expectations.

4. Take the transition to day care as slowly as possible. According to First Candle , approximately 1/3 of SIDS-related deaths in childcare occur in the first week, and half of these occur on the first day. What’s even more striking is that “babies that are at low risk for SIDS go to a high risk category on day 1 in childcare,” Blake says. Many suspect that changes in baby’s caregiver, schedule and environment are at the root of the problem. Keeping it consistent from one caregiver to another and easing into a new child-care routine can help smooth the way for the transition. Here are a few tips:

    • Visit the daycare center or meet with the nanny a few times before the official start date;
    • Talk about day care at home, no matter how young your child is;
    • Get your baby used to caretakers outside the family and outside the home;
    • Give your caretaker the inside scoop on your baby’s likes and dislikes, and do so ahead of time;
    • Don’t just drop your baby off. Spend the first few days observing and see how he takes to the caretaker (and vice versa) prior to leaving them alone;
    • Communicate with your child-care provider, and keep doing so well beyond the transitional period. This will allow you to know how your child is coping and to ensure that safe practices are still in place.

5. Spread the word. Child-care licensing and training regulations vary from state to state . This means that depending on where you live, your child-care provider may not need to update his or her training to maintain licensure. If you think your caretaker isn’t familiar with safe sleep standards, sharing your knowledge may not quite cut it. So talk to other parents around you about organizing a training event and pass the baton to the professionals! Many organizations dedicated to eliminating SIDS and other sleep-related deaths offer in-person and online educational programs to child-care centers and providers.

Photography by Desiree Walters Photography.

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