Sudden infant death syndrome is the leading cause of death for babies between the ages of 1 month and a year, with 90 percent of SIDS deaths occurring before the baby reaches 6 months of age. Research is inconclusive as to why SIDS occurs, but some have suggested there may be parental knowledge or compliance deficits.
A $22,000 grant/gift provided to the University of Alabama at BirminghamWomen and Infants Services by the March of Dimes and McDonald’s has led to an ongoing three-year education and research project called “Each One Teach One: SIDS Prevention” in an effort to curb these infant deaths.
“We don’t know what causes SIDS, and there is all kinds of speculation out there as to why it occurs — everything from babies’ faces being down near the bed sheet to whether the baby is rebreathing the carbon dioxide,” said Freda Centor, advanced nursing coordinator for UAB Women and Infants Services and lead investigator for the project. “Our current project is pioneering work in our city. We are educating parents on sleeping practices we know to be safe, and we are documenting the knowledge and compliance of our families after they leave.”
UAB is educating moms and other family members prior to their leaving the hospital that babies must sleep on their backs, as well as addressing the issue in the community with active engagement and advertising.
UAB Women and Infants Center nurses teach mothers the proper way to lay their babies down to sleep while they are in the hospital and again before they are discharged. The biggest component of this is putting the baby on his or her back every time the baby goes to sleep.
“We also recommend they use wearable blankets that fit closely to the baby and zip up so there will not be an issue with blankets’ potentially covering the baby’s face,” Centor said. “Also, we tell them no fluff — no pillows, no bumper pads, no toys in bed with the baby. They need a firm mattress with a well-fitting sheet.”
Upon discharge, nurses ask moms if they would be willing to take part in the research study. If the mom says yes, she gets a two-question test of knowledge based on what she has just been taught.
The first question: “What side should the baby always be put on when the baby goes to sleep?” The choices are back, side and stomach.
The second question: “Whom do you need to tell about this?” Moms are given a list of options that includes “my husband, baby’s father, my mother, my aunt, day care center” and others. The last option is all of the above. Those who participate are given a T-shirt for the baby that says “This side up” on the front and “Back to sleep” on the back.
“What we’re showing by doing this is that the moms have knowledge,” Centor said. “Then, two to three months after Mom and baby go home, we give them a phone call and ask one question: ‘What side did you put your baby on to sleep last night?’ This tells us whether they are being compliant.”
Centor has logged more than 1,500 responses in the first three years, and the vast majority — more than 98 percent — report that they put their babies on their backs to sleep.
“Those who answered in a noncompliant way, who say they put their babies on their sides or stomachs, have said they know they are not supposed to do that, but that their babies cry when they put them on their backs,” Centor said.
The community outreach includes a project called SIDS Sundays and specifically targets the Birmingham African-American community. Black babies die from SIDS at twice the rate of white babies, and the medical reasons for this are unknown. Centor believes it could possibly be because of long-held beliefs that go back generations when children were placed on their stomachs to sleep.
“That’s why the community piece of this project is so important,” Centor said. “In partnership with the Birmingham Black Nurses Association, we have a health educator who regularly goes out to the African-American churches in the community and teaches women and men the proper way to lay a baby down to sleep. We pass out literature and bags that say ‘I put my baby on his back to sleep’ on the side of them. We hope they will carry those bags in the community when they go shopping or to the park and that others will ask about them.”
An advertising component will be coming soon in the Birmingham area. The plan is to purchase ads that will be displayed prominently on area buses that frequent black communities.
“We also continue to train our staff and others around the state on the latest SIDS information,” Centor said. “We’ve spoken at the March of Dimes, UAB Progress and numerous statewide conferences, and we hope to speak at the national Association of Women’s Health, Obstetric and Neonatal Nurses conference next summer. This is an easy research project with a huge potential payoff — saving babies’ lives. We want to share with everyone we can.”