Wednesday, May 21, 2014

Technical Assistance On the Road: Chapters 5, 6 and 7

May has been a busy month for the Child Fatality Prevention System. We have been busy planning for the upcoming Coordinator Training in June, writing our annual legislative report and providing technical assistance to the local teams. 
Here are some highlights from my May travels:

May 1, 2014
Trip to Pitkin County

Aspen is beautiful in the Spring with its snowy mountain peaks and green valleys; I was happy to visit at such a lovely time of year. Liz Stark, Pitkin County Public Health Director and Child Fatality Prevention Coordinator, welcomed me to her first CFR team meeting. The team discussed meeting structure/ logistics and practiced reviewing a case from their county. Liz and her team did a great job with the process. 

May 12, 2014
Trip to Grand County 

Just when we though we were in the clear, mother nature threw us a snowball. Brene Belew-LaDue, Grand County Public Health Director and Child Fatality Prevention Coordinator, had invited me to attend Grand County's first CFR Meeting. As such, I got up early and braved the snowy roads to participate in this meeting. The team discussed meeting structure/ logistics and practiced reviewing a case from their county. Excellent discussion!

 May 15, 2014
 Trip to Clear Creek County

Crystal Brandt, Clear Creek County Public Health Director and Child Fatality Prevention Coordinator, invited me to her second CFR planning meeting. The team was fully formed and eager to take on their new responsibilities. We discussed meeting structure/ logistics while enjoying a hearty meal at Tommyknockers. The team has set up their next meeting date for later in the summer to practice their first case. I look forward to visiting this team again soon!

Coordinator Training Confirmations

2 Weeks Until June Coordinator Training

After finalizing numbers with the Marriott, I was able to send out confirmations for your attendance in the upcoming June training. Thank you for your patience!! If you did not receive details confirming your attendance, please let me know. 

We have several special guests coming to the training: 
Joni Reynolds Director of Public Health Programs at the CDPHE
Senators Newell and Kefalas Co-sponsors on SB 13-255 and advocates for child fatality prevention and the safety and well-being of children.
Teri Covington Director of the National Center for the Review and Prevention of Child Deaths
Review full training agenda

We are excited to have you at the training and know that it will be a beneficial learning experience for all involved!!

Many parents not following safe infant sleep practices

From:  USA Today


Although a national campaign emphasizing the importance of safe sleeping practices for babies is credited with slashing the rate of sudden infant death syndrome (SIDS) and reducing infant death from other sleep-related causes, new studies pinpoint areas where additional work is needed.

According to research being presented today at the Pediatric Academic Societies meeting in Vancouver, 19% of mothers report that they usually share a bed with their baby, an increasingly common practice that's been shown to make infants nearly three times more likely to die from SIDS than infants who sleep alone.

The bed-sharing rate was highest among Hispanic mothers (28%), compared with black (18%) and white mothers (14%), according to the research led by pediatrics professor Eve Colson of Yale University School of Medicine.

"Bed sharing is definitely on the rise," say Colson, who analyzed a nationally representative sample of 1,031 mothers recruited from 32 hospitals across the country for this new study.

Research she published last year using surveys of 19,000 caregivers in 48 states found that from 1993 to 2010 the incidence of baby bed-sharing or co-sleeping more than doubled from 6.5% to 13.5%.

Story: A N.J. mom discusses her bed-sharing decision

Based on the new data analysis, the overall rate for usually putting an infant to sleep in the prone or stomach-down position, also considered a high-risk practice, was just 9%, on target with national reduction goals, Colson says. However, the practice was reported by 20% of black mothers, compared with 10% of white and 6% of Hispanic mothers.

According to the Centers for Disease Control and Prevention, the government's Back to Sleep education campaign, first introduced in 1994, has reduced the rate of SIDS by 50%, but that decline stalled as rates of other sleep-related causes of infant death, such as accidental suffocation, have increased.

In 2012, the campaign was renamed Safe to Sleep and expanded to encompass all sleep-related, sudden unexpected infant deaths (SUID) as well as highlight theAmerican Academy of Pediatrics' recommendations for reducing them.

In addition to always putting babies on their backs to sleep and eliminating bed-sharing, the AAP recommendations include avoiding bumpers and soft, loose bedding, not letting babies overheat, and keeping them away from smokers and places where people smoke.

SIDS is the leading cause of death among infants between 1 month and 1 year of age, according to the CDC. In 2010, the most recent year that statistics were available, 2,063 deaths were reported as SIDS; 918 as cause unknown; and 629 as accidental suffocation and strangulation in bed.

It's not clear what causes SIDS, nor is there an absolute understanding of how back-sleeping protects infants, says Colson, although some ideas include "that it offers better exposure to fresh air, and the system that allows you to wake up when you're (having breathing difficulties) is better activated when you're on your back."

Another new study to be presented at the PAS conference shows that back-sleeping for infants varies widely by state and is particularly low among preterm babies two to four months after discharge from the hospital.

"The more preterm the babies were, the less likely they were to be placed on their back," says study leader Sunah Hwang, a neonatologist at Boston Children's Hospital and South Shore Hospital.

"That's particularly worrisome given that these are more vulnerable infants who are at higher risk for SIDS, sleep-related deaths and other complications," Hwang says.

Only 60% of the earliest preterm infants (born 27 weeks or less) were usually positioned on their back for sleep by parents, compared with 62% of infants born 28-33 weeks, 63% of late-preterm infants (born 34-35 weeks) and 68% of full-term infants (born at 37 to 42 weeks).

The analysis, based on data collected from new mothers of 392,397 infants born in 36 states between 2000 and 2011 also found that Louisiana had the lowest back-sleeping rate (47%) for all infants (preterm and full-term), followed by Alabama and Mississippi (49% each). Wisconsin had the highest rate (81%), followed by Wyoming and Minnesota (79% each).

In 2011, the overall back-sleeping rate was 70%, says Hwang, adding that "even in the worse performing states there has been improvement."

New parents get a ton of advice from well-meaning family and friends that can affect how they put their babies to sleep, along with media ads that may show babies in attractive but unsafe sleep environments, says Linda Fu, a pediatrician at Children's National Medical Center, in Washington, D.C. She was not involved in the new study.

At the same time, parents have to make decisions about how they will best handle exhausting middle-of-the-night wake-up calls, Fu says. But "for certain things where there's such a preponderance of evidence there's no leeway," she says. "The safest position and place for infants when sleeping is on their back and in a separate crib or bassinet next to their parents, not in the bed with them."