Teaching Parents Their ABCs

Teaching Parents Their ABCs

ABC means ‘Alone, on their Backs, and in a Crib’ — and that’s how parents are remembering the essentials for keeping their babies safe from sleep-related deaths.

by Lynn Mundell

Lisa Cowan, DNP, feels so strongly about babies sleeping safely that as the regional director of Clinical Services for Maternal Child Health at Kaiser Permanente she told her children if she could implement only one more thing in her career, it would be adoption of safe sleep practices for infants throughout Northern California.

Nurses at the Kaiser Permanente Roseville Medical Center feel the same way.

They once pooled their money, went to Target, and bought a portable crib for a new mom whose baby needed a safe place to sleep once home.

That urgency driving the infant sleep safety revolves around some staggering statistics.

Approximately 3,500 healthy infants die every year from SIDS (Sudden Infant Death Syndrome) and other sleep-related causes of infant death.

Last year, 50 percent all preventable infant deaths were attributed to unsafe sleeping practices, including being accidentally smothered by co-sleeping parents or suffocated by excess stuffed toys and blankets in the sleeping area.

For clinicians at Kaiser Permanente, the deaths are especially tragic because they should never have happened.

The Safe Baby Campaign

September is national Baby Safety Month, and Kaiser Permanente will begin a focus on overall infant sleep safety and the recommendation by the American Academy of Pediatrics that babies sleep on their backs. Throughout the month, and moving forward, Kaiser Permanente is getting the message out to parents of newborn babies at its 15 medical centers.

That message is the ABCs of Sleep: Alone, on their Backs, and in a Crib.

Alone means no co-sleeping with parents or sibling, and no stuffed animals, blankets, crib bumpers, or sleep clothing that could cover a baby’s face, since infants haven’t yet developed neck muscles to move and clear their own airways.

For the first years of life, babies should be placed near parents but in their own sleep spaces — cribs, bassinets, or “pack and plays” — with only fitted sheets. They should be on their backs, not on their stomachs. (They can have supervised “tummy time” during the day to build those neck muscles.)

“Family members may tell new parents the opposite — that they put babies to sleep on their tummies and they were fine,” Dr. Cowan said. “At Kaiser Permanente, we’re here to help parents make the best decision based on evidence-based practices.”

Kaiser Permanente physicians, nurses, and others in the hospital are starting a conversation with new parents about where they plan to sleep their babies, and then explaining the ABCs. The message is then mirrored in hospital crib cards, door hang cards, posters, and elsewhere.

All of September, newborns throughout Kaiser Permanente Northern California will receive a gift of a sleep gown with “This Side Up,” to reinforce safe sleep when they go home.

Impassioned Advocates

Ethan Cutts, MD, a Kaiser Permanente Roseville pediatrician, first spearheaded a sleep-safety program in 2008 by collaborating with community group Safe Beginnings to reduce the number of sleep-related deaths in children under age 5.

When Dr. Cutts learned that a baby died while sleeping every other week in Sacramento County, he wanted to know why.

He and his colleagues at Safe Beginnings analyzed 20 years of county data and found 4 risk factors: infants sleeping in non-infant beds, co-sleeping with a parents or sibling, sleeping on their stomach or side, or with no crib at home.

Dr. Cutts and nurses in the Mother Baby Unit focused on education and getting a crib to those families leaving the Kaiser Permanente Roseville Hospital with nowhere to sleep their baby. In the ensuring years, Kaiser Permanente Roseville and Cribs 4 Kids have given away on average 2 cribs a month.

“Our experience has shown that families are very receptive to information and education about sleeping their baby safely,” said Debbie Reitter, RN, MSN, CNS, director of the Women and Children’s Services there. “This education helps their babies get the safest start to life.”