3.6.4.5: Death

Early care and education (ECE) programs should have a plan in place for responding to any death relevant to children enrolled in the program and their families. The plan should describe protocols the program will follow and resources available to children, families, and staff.¹

If an ECE program experiences the death of a child or adult, the following should be done, and these actions can take place simultaneously ²:

• When a child dies or collapses unexpectedly, ECE staff should notify emergency medical services/personnel promptly on discovering the child and begin to administer appropriate first aid and/or cardiopulmonary resuscitation as directed.²
• Caregivers/teachers responsible for any children who may have observed or were in the same room where the collapse or death occurred should take the children to a different room.
• Immediately notify the child’s parents/guardians or adult’s emergency contact; this can include information on what hospital the child/adult is being taken to.³
• Notify law enforcement immediately and follow all law enforcement protocols regarding the scene of the death.³

1. Do not disturb the scene.
2. Do not show the scene to others.
3. Reserve conversation about the event until having consulted with and completed all interviews with law enforcement.

• Notify the licensing agency the same day the death occurs.
• ECE programs should only release specific information about the circumstances of the child’s or adult’s death that the authorities and the deceased member’s family agree that the program may share.
• Supportive and reassuring comments should be provided to children directly affected. Provide age-appropriate information for children, parents/guardians, and staff.

Depending on the cause of death (including sudden unexpected infant deaths [SUIDs], sudden infant death syndrome [SIDS], suffocation, injury, maltreatment, etc), there may be a need for updated education on the subject for caregivers/teachers and/or children as well as implementation of improved health and safety practices.

Caregivers/teachers should be knowledgeable about safe sleep practices and implement them so that sleep-related deaths are not treated as possible maltreatment cases, resulting in false, inappropriate criminal and protective services investigations of the ECE program.⁵

 

If a child or adult known to the children enrolled in the ECE program dies while not at the ECE facility ^1,3

• Provide age-appropriate information for children, parents/guardians, and staff.
• Make resources for support available to staff, parents, and children.

If a death outside the ECE program might be due to suspected child maltreatment or neglect, the caregiver/teacher is mandated to report this to child protective services. Failing to consider or follow up on a suspected child abuse/neglect case can put other children (eg, siblings, children in the extended family, those enrolled in the program) at risk.⁴

RATIONALE

Proper management of unexpected deaths of children or adults by ECE staff allows families and staff who are affected the opportunity to react, grieve, assess, and communicate their needs.⁵ A parent’s experience following the death of a child varies enormously, and the way staff respond to and support families can make a considerable difference.²

 

COMMENTS

ADDITIONAL RESOURCES

 

The following resources can offer support and counseling to caregivers/teachers and families experiencing tragedy:

 

National Action Partnership to Promote Safe Sleep

http://nappss.org

First Candle

www.firstcandle.org

 

National Center for School Crisis and Bereavement
https://www.schoolcrisiscenter.org

 

“Supporting the Grieving Child and Family”

https://pediatrics.aappublications.org/content/138/3/e20162147

 

National Center for Education in Maternal and Child Health SUID/SIDS Gateway

https://www.ncemch.org/suid-sids

TYPE OF FACILITY

Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home

RELATED STANDARDS

1.4.1.1 Pre-service Training
3.1.4.1 Safe Sleep Practices and Sudden Unexpected Infant Death (SUID)/SIDS Risk Reduction
3.4.4.1 Recognizing and Reporting Suspected Child Abuse, Neglect, and Exploitation
3.4.4.2 Immunity for Reporters of Child Abuse and Neglect
3.4.4.3 Preventing and Identifying Shaken Baby Syndrome/Abusive Head Trauma
3.4.4.4 Care for Children Who Have Experienced Abuse/Neglect
3.4.4.5 Facility Layout to Reduce Risk of Child Abuse and Neglect
9.2.4.3 Disaster Planning, Training, and Communication

REFERENCES

1. Association of SIDS and Infant Mortality Programs. The unexpected death of an infant or child: standards for services to families. http://www.stonybrookmedicine.edu/sites/default/files/asip_standards.pdf. Reviewed March 2001. Accessed May 18, 2020

2. Sidebotham P, Marshall D, Garstang J. Responding to unexpected child deaths. In: Duncan JR, Byard RW, eds. SIDS: Sudden Infant and Early Childhood Death; The Past, the Present and the Future. Adelaide, South Australia, Australia: University of Adelaide Press; 2018. https://www.ncbi.nlm.nih.gov/books/NBK513395. Accessed May 18, 2020

3. National SIDS/Infant Death Resource Center. Responding to a Sudden, Unexpected Infant Death: The Professional’s Role. Vienna, VA: National SIDS/Infant Death Resource Center; 2004. https://www.ncemch.org/suid-sids/documents/SIDRC/ProfessionalRole.pdf. Accessed May 18, 2020

4. Palusci VJ, American Academy of Pediatrics Council on Child Abuse and Neglect, Kay AJ, et al. Identifying child abuse fatalities during infancy. Pediatrics. 2019;144(3):e20192076 PMID: 31451610 https://doi.org/10.1542/peds.2019-2076

5. Palusci VJ. Pediatricians have critical role in identifying child abuse fatalities during infancy. AAP News. ttps://www.aappublications.org/news/2019/08/26/childabuse082619. Published August 26, 2019. Accessed May 18, 2020

NOTES

Content in the STANDARD was modified on 05/17/2016 and 8/25/2020.