Caring for Our Children: National Health and Safety Performance Standards for Out-of--Home Child Care Programs, 2nd Edition (
CFOC, 2nd Ed.)was released by the American Academy of Pediatrics (AAP), American Public Health Association (APHA), the Maternal and Child Health Bureau (MCHB), and the National Resource Center for Health and Safety in Child Care (NRC) in January 2002. The full edition of
CFOC, 2nd Ed. contains 707 standards and recommendations on all aspects regarding the health and safety of children in child care settings. These standards were developed by leading health and safety experts over a period of four years. Each standard includes rationale behind the need for such practices. The full edition is available on the NRC web site at
http://nrckids.org/CFOC/index.html. Print copies can be purchased from the American Academy of Pediatrics (www.aap.org)and the American Public Health Association (www.apha.org).
In an effort to make select subject areas more accessible to intended users, the National Resource Center for Health and Safety in Child Care (NRC) is developing smaller documents on specific subject areas. This document is a compilation of the standards on reducing the risk of Sudden Infant Death Syndrome (SIDS) in child care settings.
Sudden Infant Death Syndrome (SIDS) is the sudden death of an infant under 1 year of age, which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history (1).
In 1992 the American Academy of Pediatrics (AAP) issued a statement advising side/back sleep positions for infants in order to reduce the risk of SIDS. (In 1996 the AAP revised this recommendation saying that placement on the back is the preferred sleeping position for all healthy infants.) 1992 was also the year the first edition of
Caring for our Children, National Health and Safety Performance Standards: Guidelines for Out-of-Home Child Care Programs was released by a partnership consisting of AAP, APHA, and MCHB. Because the publication of
Caring for Our Children came before the AAP statement on sleep position was issued, the first edition of
Caring for Our Children did not contain standards on SIDS. In 1994 the National Institute for Child Health and Human Development in partnership with MCHB, AAP, SIDS Alliance and the Association of SIDS Program Professionals launched the Back to Sleep Campaign recommending placing infants on their backs to sleep in order to reduce the risk of SIDS. The campaign has enlisted many partners all working to assure the widest possible outreach with information and education to hospitals, health care providers, parents, grand parents and communities. Since the Back to Sleep Campaign was launched, the rate of SIDS has dropped from over 5,000 to under 3,000 infant deaths per year.
Child care providers touch the lives of young children and their families in many important ways and need to be included in special efforts to extend the reach of the Back to Sleep Campaign. Launched in June 2002, the Healthy Child Care America's Back to Sleep Campaign represents one such special effort. The goal of Healthy Child Care America's Back to Sleep Campaign is to prevent SIDS in child care settings. The initiative works to achieve this goal by educating child care providers, parents and policy makers on risk reduction practices for SIDS and supporting States in their efforts to include safe sleep practices in their child care licensing regulations. This compilation of 10 standards on SIDS from the 2nd Edition of
Caring for Our Children supports the Healthy Child Care America's Back to Sleep Campaign objective to educate child care providers, parents and policy makers on risk reduction practices for the prevention of SIDS.
Throughout this document there will be references to other standards contained in the full edition of
Caring for Our Children, 2nd Ed. For example, in Standard 5.146 regarding soft bedding, the rationale refers to Standard 5.145 (which is in the full edition) for more information on appropriate cribs. In the web version, the user can click on the link to this standard to get to the full edition.
The intended audiences for this document are:
1) child care providers who can implement these cost free strategies and reduce the number of SIDS related deaths in child care
2) state regulators and policy makers who can promote the adoption of risk reduction methods into their state licensing standards
3) health consultants and trainers who can promote and teach these strategies to child care providers
4) parents who can demand the use of these strategies in their child's child care setting
We would like to give special thanks to Phyllis Stubbs-Wynn, MD, MPH, for her leadership in the development of the Healthy Child Care America's Back to Sleep Campaign. Thanks also goes to Andrea Furia, BA, BS, Kathleen Fernbach, BSN, RN, PHN, and George Askew, MD, FAAP, for reviewing this compilation of SIDS risk reduction standards. We would also like to thank all those individuals who contributed to
CFOC, 2nd Ed. A listing can be viewed at:
http://nrckids.org/CFOC/PDFVersion/Acknowledgments.pdf
As with all areas in health, new research comes forth and we recommend that users continue to visit the following web sites for the most up-to-date information on SIDS risk reduction measures:
American Academy of Pediatrics
American Public Health Association
Association of SIDS and Infant Mortality
Programs
Consumer Product Safety Commission
National Institute of Child Health and Human Development
http://www.nichd.nih.gov/sids/
National SIDS Resource Center
http://www.sidscenter.org/
http://www.sidsalliance.org/
For questions or assistance on these standards or
Caring for Our Children, 2nd Edition, please contact:
National Resource Center for Health and Safety in Child Care
(1)Willinger M, James LS, Catz C. Defining the sudden infant death syndrome (SIDS): deliberations of an expert panel convened by the National Institute of Child Health and Human Development. Pediatr Pathol. 1991;11:677-684
