SIDS and safe sleeping - advice

This advice provides additional information regarding Sudden Infant Death Syndrome (SIDS) and safe sleeping arrangements for children under two years.

Introduction

See procedure SIDS safe sleeping assessment for tasks that must be undertaken.

Child protection practitioners are required to discuss SIDS risk factors with parents and carers and provide information about the ways to reduce these risks for infants. Child protection practitioners are also required to sight and record the child's sleeping arrangements.

SIDS was previously called cot death. It is listed as the cause of death when an infant dies suddenly, usually during sleep, and all other possible causes for the death are excluded. SIDS is the major cause of death for infants under one year in Australia.

Families subject to child protection intervention are a significant sub group of the population at increased risk of SIDS. Many of these families are considered hard to reach using traditional public health education strategies and appear to require more direct intervention to ensure these messages are understood.

Child protection practitioners are likely to have contact with families in which an infant may be at an elevated risk of sudden infant death and are in a good position to alert families to known SIDS risk factors. The specific requirements are set out in the standard below.

Child protection practitioners working with young infants should familiarise themselves with and refer to relevant and current practice advice and guides.

Risk factors

In 1990 the Sudden Infant Death Research Foundation (SIDRF) introduced the 'Reducing the risk of SIDS' campaign. The campaign highlighted three modifiable childcare practices to address SIDS risk factors:

  • babies should be put on their backs to sleep
  • babies should be in smoke free environments, before and after their birth
  • babies' heads and faces should remain uncovered during sleep.

Sharing a sleeping surface (co-sleeping) with an infant increases the risk of SIDS and fatal sleep accidents in some circumstances:

  • There is a very high-risk of infant death and sleeping accidents when an infant shares a sofa or couch with an adult during sleep. Infants must never be left alone on an adult bed or put to sleep on a sofa.
  • Adult sleeping environments may contain hazards that can be fatal to infants. These risks include lying on the infant by someone under the influence of alcohol or sedating drugs; entrapment or wedging between the mattress and another object such as a wall; head entrapment in bed railings, and suffocation from pillows and blankets.

When is sharing a sleep surface not safe?

Sharing a sleep surface with an infant must be avoided in the following circumstances where:

  • the infant shares the sleep surface with a smoker
  • there is adult bedding, doonas or pillows that may cover the infant
  • the infant can be trapped between the wall and bed, can fall out of bed or could be rolled on
  • the parent is under the influence of alcohol or drugs that cause sedation or is overly tired
  • infants are sharing beds with other children or pets
  • the infant is placed to sleep on a sofa, beanbag, waterbed or sagging mattress.

Protective Factors

The following actions will reduce the risk of sudden infant death:

  • sleep infant on the back from birth, not on the tummy or side
  • sleep infant with head and face uncovered (no doonas, pillows, lambs wool, bumpers or soft toys)
  • avoid exposing infants to tobacco smoke before birth and after
  • provide a safe sleeping environment (safe cot, safe mattress, safe bedding)
  • sleep infant in it's own safe sleeping environment next to the parents' bed for the first six to 12 months of life.

Responses may also include but are not be limited to:

  • referral to maternal and child health nurse
  • provision of written educational material at appropriate reading level - see http://www.sidsandkids.org/safe-sleeping
  • direct discussion with the family concerning SIDS risk factors and ways to alleviate them
  • provision of material goods (for example, cots or bedding) to reduce risk of SIDS risk factors

Further information regarding the risk factors and appropriate practice responses where these factors are present can be found at SIDS and Kids Victoria.

Where police are investigating suspected deaths from SIDS, the child protection protocol with the Victoria Police enables them to contact Child Protection (Statutory and Forensic Services Branch and the After Hours Child Protection Emergency Service) to ascertain if the child or their siblings are child protection clients and for this information to be released.

Reunification of an infant

Where a child under two years is to be reunified with a parent or caregiver, a visit should be made to the home prior to the child returning to the carers’ or parents’ care to confirm safe sleeping arrangements.

Considerations for good practice

Where child protection practitioners become aware of SIDS risk factors and other protective issues within a family with whom they are working, a referral to the local maternal and child health nurse should be discussed with the family and active support provided to facilitate contact.

Failure by a parent to adequately address SIDS risk factors in the face of explicit requests to do so, may form part of the evidence underpinning an application to the Children's Court.

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