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From 2000-2003 our county had 57 infant deaths due to Sudden Infant Death Syndrome (SIDS).  The SIDS rate for black infants was 3.5 times higher than that of white infants, which was higher than the national average.  The American Academy of Pediatrics (AAP) issued a policy statement in 2005 stating they no longer recognized side sleeping as an appropriate sleep position for infants, and no soft bedding or objects were to be placed in the infant crib.

A county task force consisting of public health agencies, local hospitals, and community agencies was convened.  The goal of this task force was to reduce the incidence of SIDS and other infant sleep related deaths.  Funding for this initiative was a minimal grant.

Hospital members of the task force identified nurses as role models for parents/families. Current hospital practice was side-sleeping.  The county has seven local birth hospitals delivering over 20,000 babies per year. The initial step was to assess how infants in well baby nurseries were placed in their cribs.  Observational audits and nurse surveys were performed.  97% of the nurses surveyed knew infants were to be placed on their back to sleep yet 50% of nurses placed infants in a side-lying position. Their biggest fear was aspiration.  The audits revealed 50% of infants were placed on their back, while 50% were placed on their side, 23% had extra blankets and 13 % had toys.

These findings confirmed the critical need for infant safe sleep education targeted at the healthcare professional in the hospital setting. A standardized PowerPoint education program was developed.  Each birth hospital was given the autonomy to educate their staff using the standardized curriculum in any method they preferred.  The following challenge arose; each institution had differing readiness for implementation.  It took six months for all hospitals to implement the education.  The aggregate data one year after successful implementation of hospital staff education was:  96% of babies were on their back, 1% of cribs had extra blankets, and 1% had toys. Addressing infant safe sleep in the hospital setting positively influenced staff behavior. Hospital audits continue.

With parents now visualizing infant safe sleep practices in the hospital, the task force began focusing efforts on educating office nurses, home health care professionals, and childcare providers. The task force applied for grants.  Two small grants of less than $5,000 total were received. With these monies, a program targeted at office nurses and home health care professionals was given; and 150 childcare providers were educated in three Saturday conferences. To create community awareness about the incidence of SIDS and infant safe sleep practices, an infant safe sleep brochure targeted at grandparents was developed and a general forum for the community is being planned.

This innovative initiative demonstrated collaborative effort across public health agencies, hospitals, and community agencies can be organized around a public health issue. Positive change can occur with dedicated multidisciplinary task force members.