Infant Safe Sleep Campaign January 2014 Janice A. Freedman, MPH, Executive Director Tania Connaughton-Espino, MPH Infant Safe Sleep Coordinator

Healthy North Carolina 2020 Maternal and Child Health Goals Reduce infant mortality rate to 6.3 per 1,000 live births Reduce the infant mortality racial disparity between whites and African Americans to 1.92 Reduce the percentage of woman who smoke during pregnancy to 6.8%

North Carolina Healthy Start Foundation Mission: To eliminate preventable infant death and illness in North Carolina – Statewide, private nonprofit established in 1990 – Long history of creating and conducting on-going public education campaigns in English and Spanish – Provide professional and community-based training and technical assistance – Advise state and local policy makers – Qualitative research

SIDS & Infant Safe Sleep Definitions: SIDS: The sudden, unexpected death of a seemingly healthy infant for whom no cause of death can be found after: Autopsy Death scene investigation Review of baby’s medical history Sleep Related Infant Deaths: Most likely involve suffocation, overlay or entrapment.

2012 Data From the NC Medical Examiners Office: 119,767 births 28 SIDS deaths 101 additional deaths related to sleep environment – 31 Asphyxiation or suffocation – 70 Undetermined

North Carolina SIDS Death Rates (per 1,000 live births)

Disparities NC State Center for Health Statistics NORTH CAROLINA INFANT MORTALITY REPORT SIDS Death Rates (per 1,000 live births) by Race and Year

Number of NC Infant Deaths in Sleep Environments

2011 AAP Recommendations Back to sleep (front to play) Place your baby to sleep on a firm sleep surface. Keep soft objects and loose bedding out of the crib Room-sharing in a crib or bassinet (no bed-sharing or couch-sharing) Breastfeeding is recommended Schedule and go to all well-child visits and get all recommended immunizations

2011 AAP Recommendations Avoid smoke exposure during pregnancy and after birth Avoid alcohol and illicit drug use during pregnancy and after birth Avoid overheating Offer a pacifier Avoid any products that claim to reduce the risk of SIDS Get regular prenatal care

What Has Made a Difference? Baby’s Easy Safe Sleep Training

NC’s Public-Private Partnership North Carolina Healthy Start Foundation Child Fatality Task Force (funding & support) Division of Public Health (WCH) (funding & support) Office of Chief Medical Examiner (stats) CBOs Local Health Departments Schools & Community colleges (BESST) Hospitals (HOPES) Public (media outreach) DCD (ITS-SIDS: child care policy and training) ww.mamasana.org

History: North Carolina Safe Sleep 1990 NC highest IM rates in US - NCHSF founded 1994 NC’s Back to Sleep Campaign started 2003 NC SIDS Law for Childcare: ITS-SIDS 2005 BESST begins to strengthen community outreach HOPES begins with Advisory Group & 5 hospitals years of state funding $150,000 - $202,000 for statewide campaign

History: North Carolina Safe Sleep 2011 New AAP SIDS/Sleep- Related Infant Death Policy 2011 Hospital Model of Excellence Award 2012 NC joins national COIIN initiative 2012 NC SIDS deaths at all-time low 2013 On-line BESST training (CHES and nursing credits)

NC Infant Safe Sleep Campaign (formerly NC Back to Sleep) Established in 1994 Partnership with Division of Public Health (WCH) Adheres to American Academy of Pediatrics (AAP) Standards Uses evidence-based research, epidemiology, principles of public health Messages and materials available in English and Spanish Nationally recognized for cultural competence, outreach and social marketing

HOPES: Hospital Outreach and Partnerships for Educating about Infant Safe Sleep Goal: All NC hospitals will be part of a statewide effort to reduce the risk of SIDS and prevent sleep-related infant deaths. Objectives: – To help hospitals develop or strengthen policies and procedures based on best practices. – To improve the capacity of N.C. hospitals to provide evidence-based, infant safe sleep training for well-baby nursery, NICU and pediatric nursing staff. – To increase patient and caregiver practice of infant sleep safety by providing educational materials and modeling safe sleep behaviors.

Hospital Infant Safe Sleep Model of Excellence Started in 2011 Recognizes hospitals meeting criteria in 4 areas – Policy – Staff training and education – Patient education and modeling – Community outreach Endorsed by CFTF and NC Hospital Association To date 12 Models of Excellence and 5 Leaders

BESST Baby’s Easy Safe Sleep Training Offers important tips about infant safe sleep and ways to reduce the risks of SIDS. The kit includes an: – Educational flip chart – Infant safe sleep guide On-line training hours of nursing and CHES credits On-site training available BESST Kit available for sale at:

Resources: Webisodes What is an infant safe sleep space? How to overcome the challenges of infant back sleeping How to overcome the challenges of infant back sleeping Where should your baby sleep? Introduction to BESST flipchart FAQ's about safe sleep Sharing safe sleep messages with Latina moms ¿Cómo es un lugar seguro para dormir a un bebé? (What is an infant safe sleep space?) ¿Cómo es un lugar seguro para dormir a un bebé? (What is an infant safe sleep space?)

Television Ad

Call to Action: In Your Agency Staff training (not just SIDS Counselors) Encourage staff to do on-line BESST training Identify opportunities to educate families: – Prenatal clinic – Child health clinic – WIC clinic – Outreach programs (Adolescent Parenting Program) – Home visiting programs (CC4C, NFP, etc.)

Call to Action: In the Community Put on Child Fatality Prevention Team agenda Engage local hospital(s) in HOPES Exhibit/demonstrate in community fairs Partner with the media (“Danger” ad, press releases, letters to the editor, etc.) Participate in SIDS Awareness Month activities (October)

New Ideas Community event for families to trade in bumper pads for sleep sacks Involvement of fire department/first responders to evaluate safe sleep environment when called to house Others???? g

Contact Information Tania Connaughton-Espino: Janice Freedman: Phone: NC Healthy Start Foundation Web Sites: English: Spanish: