1. S AFE B EGINNINGS A PREVENTION PROGRAM FOR S ACRAMENTO C OUNTY TO REDUCE INFANT SLEEP - RELATED DEATHS IN CHILDREN AGES 0-5 1 PRE-TEST Please take a few minutes to take the pre-test.

2. T EST R EVIEW Q UESTIONS ? 2

3. Almost all (90 of the 95 deaths) had at least one known infant sleep environmental risk factor: 3 95 Infant Sleep Related Deaths in Sacramento County from 2007-2011

4. S AFE B EGINNINGS C OLLABORATIVE F OCUS G ROUPS 4 What do you know about infant sleep-related deaths? … they are a completely natural phenomenon. …believe parents have little ability to prevent these deaths …agreed Infant sleep-related deaths are a major problem …heard of infant sleep- related deaths on TV, but not within their families/communities What do you think are the major risk factors for infant sleep-related deaths? Co-sleeping Infant sleeping somewhere other than a crib Infant sleeping on their tummy Parent ResponseProvider Response

5. Sacramento County parent and service providers focus group participants overwhelmingly agreed: An education campaign to raise awareness of the importance of infants (particularly those 6 months of age and younger) sleeping in safe environments was needed for Sacramento County. With information delivered by: Birthing Hospitals Health Care Professionals Child Care Providers Family Resource Centers Community Programs 5

6. ABC’ S OF I NFANT S AFE S LEEPING V IDEO 6

7. S ACRAMENTO C OUNTY ABC’ S OF I NFANT S AFE S LEEPING A for Alone Babies should always sleep alone in their own crib or bassinette. Co-sleeping with other children or even parents can be dangerous – others in bed with your baby can accidentally suffocate them by simply lying too close to their mouth or nose, or by rolling onto them while asleep. Your baby should not sleep with stuffed animals, pillows or blankets — these soft items could accidentally fall over your baby’s face and suffocate them. A blanket sleeper or sleep sack is enough to keep your baby comfortable. 7

8. S ACRAMENTO C OUNTY – ABC’ S OF I NFANT S AFE S LEEPING B for Back Babies who sleep on their backs are much less likely to die of infant sleep-related deaths. According to doctors, “back sleeping” will not increase a baby’s risk of choking. Many of our own mothers and grandmothers were taught to put a baby on their tummy to sleep — so you’ll need to gently remind them that to prevent infant sleep-related deaths, it’s “back to sleep.” 8

9. S ACRAMENTO C OUNTY – ABC’ S OF I NFANT S AFE S LEEPING C for Crib Cribs and bassinets are the safest places for babies to sleep – as long as you keep them safe! To make breastfeeding easier keep a crib or bassinet next to your bed and always put your baby back to sleep afterwards. Cribs should be free of pillows, bumpers, stuffed toys, extra blankets or anything that could accidentally cover your babies face and suffocate them. A blanket sleeper or sleep sack is sufficient. Make sure that the crib mattress is firm and fits snuggly with no space between the mattress and the side of the crib, where the baby could become trapped. Unlike firm crib mattresses, today’s adult beds are soft and can cause babies to suffocate. 9

10. I NFANT S LEEP -R ELATED D EATHS : A Q UICK AND S ILENT K ILLER Infant sleep-related deaths are the leading cause of death for babies one month to one year of age. Most babies that have an infant sleep-related death appear to be healthy prior to death. Infant sleep-related deaths occur in all socio-economic, racial and ethnic groups. African American and Native American babies are 2-3 times more likely than Caucasian babies to have an infant sleep-related death. 10 www.firstcandle.org

11. T RIPLE R ISK M ODEL 11 Vulnerable Infant Critical Development Period (2-4 months) Sleep Environment Risk Factors SIDS Infant Sleep- Related Deaths

12. I NFANT S AFE S LEEPING Recent research from the American Academy of Pediatrics indicates that infant sleep-related deaths can be prevented by implementing safe sleeping techniques for every nap and every night. Recommendations for sleep position and environment should be used consistently for infants up to 1 year of age. 12

13. A MERICAN A CADEMY OF P EDIATRICS E STABLISHED R ISK F ACTORS P ART 1: 13 Maternal smoking during pregnancy Young maternal age Late or no prenatal care Maternal drinking and /or drug use SIDS and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment; Pediatrics Journal, October 2011 Male sex African American Native American

14. 14 A MERICAN A CADEMY OF P EDIATRICS E STABLISHED S LEEP E NVIRONMENT R ISK F ACTORS & R ECOMMENDATIONS : Room-sharing without bed-sharing is recommended. Risk Factor: Co-Sleeping

15. A MERICAN A CADEMY OF P EDIATRICS E STABLISHED S LEEP E NVIRONMENT R ISK F ACTORS & R ECOMMENDATIONS : 15 Risk Factor: Sleeping on stomach or on side. Sleep Environment Risk Factors: Extra items in the crib: bumpers, quilts, blankets, toys Overheating Environmental tobacco smoke Recommendation: Back to sleep always, for every sleep.

16. 16 A MERICAN A CADEMY OF P EDIATRICS E STABLISHED S LEEP E NVIRONMENT R ISK F ACTORS & R ECOMMENDATIONS : Risk Factor: Soft sleep surface (adult bed, couch or pillow) Recommendation: Firm Sleep Surface Recommendation: Keep soft objects out of the crib

17. 17 A MERICAN A CADEMY OF P EDIATRICS E STABLISHED S LEEP E NVIRONMENT R ISK F ACTORS & R ECOMMENDATIONS : Risk Factor: Overheating Recommendation: No more than one more layer than an adult would wear to be comfortable. Recommendation: Infant clothing that is designed to keep infants warm without possible head covering or entrapment (such as loose blankets).

18. 18 Recommendation: Supervised tummy-time while awake … …beginning at as early of an age as possible, to promote motor development. A MERICAN A CADEMY OF P EDIATRICS I NFANT S AFE S LEEPING 2011 R ECOMMENDATIONS

19. 19 Recommendation: Breastfeeding lowers the risk Put your baby back into his or her own crib to sleep after feeding. A MERICAN A CADEMY OF P EDIATRICS I NFANT S AFE S LEEPING 2011 R ECOMMENDATIONS

20. 20 A MERICAN A CADEMY OF P EDIATRICS I NFANT S AFE S LEEPING 2011 R ECOMMENDATIONS When breastfeeding, wait 3-4 weeks to introduce the pacifier until the baby has a good latch. Recommendation: Consider offering a clean, dry pacifier at nap and bedtime, but do not force it. If you are breast- feeding consult your lactation consultant and/or your doctor.

21. P OST - TEST 21 Please take a few minutes to take the post-test.

22. M EDICAL R ESOURCES If you do not have health insurance or a primary care provider, please contact your local Family Resource Center for more information on the Medi-Cal program. Or Contact: Medi-Cal Fresh Service Center (916) 874-3100 https://www.mybenefitscalwin.org/ TDD/TTY, Hearing Impaired (916) 874-2599 Services provided by the Medi-CalFresh Service Center are for cases managed by Sacramento County only. 22

23. 23 S ACRAMENTO C OUNTY F AMILY R ESOURCE C ENTERS La Familia Counseling Center 5523 34 th Street Sacramento, CA 95820 (916) 452-3601 North Sacramento Family Resource Center 1217 Del Paso Blvd. Sacramento, CA 95815 (916) 679-3743 Folsom Cordova Community Partnership 10665 Coloma Rd., Suite 200 Rancho Cordova, CA 95670 (916) 361-8684 River Oak Family Resource Center 4322 4 th Avenue Sacramento, CA 95817 (916) 244-5800 The Effort Resource Center 6015 Watt Avenue, Suite 2 North Highlands, CA 95660 (916) 679-3925 The Firehouse - Mutual Assistance Network 810 Grand Avenue Sacramento, CA 95838 (916) 567-9567 Meadowview Family Resource Center 2251 Florin Road, Suite 158 Sacramento, CA 95822 (916) 394-6300 Valley Hi Family Resource Center 7000 Franklin Blvd., Suite 820 Sacramento, CA 95823 (916) 290-8281

24. A CCESSING R ESOURCES Child Abuse Prevention Center www.thecapcenter.org Sacramento County WIC offices http://www.dhhs.saccounty.net/PRI/WIC/Pages/Women-Infants-and- Children-Home.aspx First Candle www.firstcandle.org American Academy of Pediatrics www.aap.org Halo Sleep Sack www.halosleep.com 24

25. E VALUATIONS Are there any other questions? Please take a minute and fill out the evaluation. Thank you!! Becky Honig, M.S. (916) 244-1938 bhonig@thecapcenter.org 25