SIDS in Child Care Settings

When a tragic infant death occurs at a child care facility, strict scrutiny of the business’s policies, programs, and procedures must take place to determine whether there was negligence on the part of the facility.  If negligence can be established, a wrongful death lawsuit against the child care facility may be an option. 

Cases of Sudden Infant Death Syndrome (SIDS) and Sudden Unexpected Infant Death (SUID) within a child care setting require an analysis of the facility’s practices with regard to safe sleeping. The question in such a legal matter, which should be addressed by a skilled personal injury attorney is: what is the standard of care for the prevention of infant crib death in child care settings?

The Risk of SIDS and SUID

The first year of life is critical for infant development.  SUID and SIDS can occur at any point in time between one to twelve months of age.  SIDS, which also goes by the name of crib death, falls under the umbrella of SUID.  SIDS usually occurs within the first four months of life and accounts for approximately 46% of the 4,000 SUID tragedies that occur every year in the United States. Besides SIDS, other SUID sleep-related fatalities involving infants have resulted from entanglement or entrapment hazards within the baby’s sleep environment.

Safe Sleep Recommendations

During the 1990s, the American Academy of Pediatrics (AAP) issued safe sleep recommendations for infants, in order to educate the public about crib death. The initiative evolved into the “Safe to Sleep” campaign in 2012.  That campaign has helped reduce the number of infant crib deaths in our country.  “Safe to Sleep” promotes putting babies to sleep on their backs (supine), and not on their stomachs (prone).  The campaign also educates parents, guardians, and caregivers on how to provide safe infant sleeping environments. The safe sleep recommendations issued by the AAP are supported by a number of other organizations, including the Centers for Disease Control and Prevention (CDC) and the U.S Department of Health and Human Services (HHS).

Childcare Facilities Update Sleep Practices

With the updated AAP recommendations with regard to SIDS, childcare facilities adjusted their infant sleep practices in order to comply with state licensing regulations.  Though SIDS deaths have significantly declined, they do, unfortunately, continue to occur. Statistics show that as many as 20% of crib-related deaths occur in child care settings.  According to the Human Resources and Service Administration (HRSA), the risk of SIDS is increased for a younger infant who has recently transitioned from home to a child care setting outside of the home.  Given that, it is crucial that the pre-enrollment process within the child care facility gather information regarding the baby’s sleep routine, including sleep positioning.  Other important information to obtain includes the infant’s medical history and general temperament.  Open communication between the parent or guardian and the child care provider is key to fostering safe sleep practices at home and within the child care setting.

California Law on Infant Safe Sleeping

California is one of at least 12 states that require special training regarding SUID/SIDS for child care personnel, emergency medical technicians, firefighters, and law enforcement. California Health & Safety Code Section 1596.847 prohibits child daycare facilities from having or using on the premises cribs that are unsafe for an infant. It also directs the Department of Social Services to provide instructional materials and information regarding SIDS.  This includes explaining the medical effects of the condition and promoting measures that could reduce the risk to child care facilities that are licensed to provide care to children under the age of two. 

Evaluating Sleep Safe Procedures in Child Care Facilities

The standard of care for child care facilities is shaped by national standards, state licensing regulations, and industry best practices. When investigating a SUID/SIDS incident within a child care setting, forensic experts will commonly investigate a range of issues, including:

Procedures and Policies

• Has the facility implemented and enforced a safe sleep policy that requires infants to be placed only on their backs (supine), and not on their side or stomach (prone)?
• Does the facility use firm crib sleep surfaces that meet safety standards?
• The sleeping environment should be free from entanglement hazards such as blankets, pillows, toys, soft bedding, bumper pads, and other such items.
• The head or face of a sleeping infant should not be covered.
• If an infant has a medical condition that prohibits back sleeping, there should be a signed waiver on file.
• What are the procedures for supervising napping infants?
• What are the supervision requirements for the staff of infant caregivers?

Other Program Design Considerations

• Elimination of any potential entanglement or entrapment risks from the infant sleep area, such as suspended mobiles, window blind cords, clothing or pacifier strings, and gaps between the crib rails and mattress.
• There should be clear visibility of the crib area by the staff.
• Temperature guidelines for infant rooms so babies do not get overheated.
• Staff training should include pre-hire and annual updated training specific to SIDS, safe sleep practices, and safe sleep environments.

Watch the YouTube Video from the American Academy of Pediatrics on the heartbreak of SIDS.

Personal Injury Lawyer in Sacramento, California

Thank you for reading.  My name is Edward A. Smith, and I’m a Sacramento-based personal injury lawyer.  For almost 40 years, I have been a tireless advocate for injured Sacramentans, as well as Northern Californians from other regions.  If you have had the tragic experience of having an infant pass away in a child care setting, please reach out to my office for compassionate, free, and friendly advice.  Our office numbers are (916) 921-6400 or (800) 404-5400.  If it is your preference, you may also contact me online.

Image by ErikaWittlieb from Pixabay

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