Loading

Annals of Nursing and Practice

Nurses’ Role in Parental Education on Sudden Infant Death Syndrome Risk Reducing Strategies

Editorial | Open Access | Volume 1 | Issue 1

Corresponding Authors
CITATION

Gelfer P (2014) Nurses’ Role in Parental Education on Sudden Infant Death Syndrome Risk Reducing Strategies. Ann Nurs Pract 1(1): 1004.

EDITORIAL

Sudden Infant Death Syndrome (SIDS) continues to be a phenomenon of unknown cause and despite a significant reduction in its rates, it remains the third leading cause of infant mortality in the United States [1]. Although it’s not possible to predict which infant will die from SIDS, the risk of an occurrence is increased by certain factors, such as premature birth, low birth weight, male gender, infants of African American and American Indian descent, exposure to tobacco smoke, and prone sleeping [2]. Epidemiologic studies have demonstrated a strong association between infant sleeping position, sleeping environment, and SIDS [2].

Starting in 1994, the Back to Sleep campaign began spreading ideas of safe sleep practices within communities and educating caregivers and health care providers on SIDS reducing strategies. The campaign has been associated with a more than 50% decline in deaths from SIDS since its beginning up to the year 2000, but for the past decade, the SIDS rate has remained constant [3]. Despite the success of the Back to Sleep campaign, the SIDS rate remains rather high and the majority of these deaths still occurred when safe sleep recommendations were not followed [4-6]. In 2012, the expanded campaign called Safe to Sleep was launched by the National Institute of Child Health and Human Development to revamp safe sleep practices. Its goals are to incorporate new and evolved science based information on safe infant sleep and SIDS reducing strategies as well as to reach out to every community with ethnically sensitive messages [7].

 The exact cause of SIDS is yet unknown, but the Triple-Risk Model represents the current trend of thought. Researches postulate that sudden death can happen if an infant with an underlying physiological vulnerability is challenged by an environmental stressor during a developmentally critical period. Environmental stressors (sleeping position and environment) are only modifiable factors and by removing them we can potentially decrease the incidence of SIDS and save lives. The American Academy of Pediatrics (AAP) guidelines stress the following preventive Safe Sleep Practices (SSP) as successful strategies to reduce SIDS risk: supine only sleeping, a firm sleeping surface, no soft objects in the crib, no bed sharing, and the avoidance of overheating and smoking (see Table 1 for the full list of recommendations) [2].

Table 1: The AAP recommendations on safe infant sleep and SIDS risk reducing strategies

Sleeping practices

Back to sleep for every sleep, no side sleeping

• Use a crib/bassinet that conforms to the safety standards

• Firm sleeping surface

• No loose soft objects in bed

• Room sharing without bed sharing • Avoid overheating

• Offer a pacifier during sleep

• No sleeping in sitting devices (car seats, swings)

• No devices promoted to make bed sharing protected (wedges, positioners)

Feeding practices

• Promote breastfeeding

Health care maintenance

• Regular prenatal care

• Avoid smoke exposure, alcohol, illicit drug use during pregnancy and after birth

• Immunizations in accordance with the AAP recommendations

• Supervised, awake tummy time

Home monitoring

• Home cardiorespiratory monitors are not a strategy to reduce SIDS

The acceptance of SSP by parents is key to decreasing the risk of unexpected deaths. Nurses and other medical personnel play critical roles in parental education. Furthermore, the way infants are positioned for sleep in the hospital has been shown to strongly influence parental practice at home [8-10]. SSP and SIDS reducing strategies are typically introduced to parents by bedside nurses as part of routine newborn care or by clinicians during well child visits. However, there is a disjunction between SIDS prevention measures and their implementation by nurses and physicians involved in the care of neonates. Hospital surveys showed that about 90% of nurseries consider the side sleeping position as an acceptable practice and only 42% to 64% of nurses 

(depending on the component of SSP) identified themselves as always following the correct sleep recommendations prior to discharge [11-13]. Another survey revealed that just half of neonatal nurses advised parents to place their infants exclusively supine for sleep after discharge [14].

To serve as role models and educators, nurses need to feel knowledgeable about the information they present to families. One of the common concerns voiced by nurses has been whether the supine position increases the risk of aspiration, especially among infants diagnosed with gastroesophageal reflux. Indeed, multiple studies from different countries have demonstrated no increased incidence of aspiration since the change to the supine position [2]. The only exception is infants with anatomic abnormalities of the upper airway with impaired airway protective mechanisms. Elevating the head of the infant’s crib is not recommended. It is ineffective in reducing reflux symptoms; in addition, it might result in the infant sliding to the foot of the crib which may compromise respiration [2].

Another concern is related to an increase in positional plagiocephaly from prolonged supine sleeping. This condition is generally temporary because babies’ skulls round out as they grow and become more active. Supervised, awake tummy time and avoidance spending too much time in seating devises such as bouncers or car seats will help to decrease pressure on the back of the head. An additional benefit of tummy time is the promotion of motor development, especially upper body muscle development.

Staff in hospital nurseries and all health care providers should be educated concerning safe infant sleep, practice it while caring for infants prior to discharge, and provide appropriate education for caregivers. Nonetheless, in its updated recommendations from 2011, the AAP stressed that hospitals should endorse and model the SIDS risk-reduction recommendations for all clinically stable infants significantly before the infant’s anticipated discharge and in the case of premature infants, by 32 weeks corrected gestational age [2]. Nurses have a unique opportunity to achieve a valuable patient- provider relationship with new parents and thus educate and influence the family. By developing trusting ties with families, nurses can ease parents’ fears and address any concerns that may serve as barriers to compliance.

After discharge, SIDS education should continue at all infant health care visits, including well child care or sick visits, until the infant turns one year of age. There is also improvement to be made in this area. During one cross-sectional survey, almost all clinicians agreed on importance of SIDS education, but 30 % admitted to not discussing it at all [15]. To continue to fight the SIDS rate, all health care providers must take responsibility for educating themselves and others about SSP and SIDS reducing strategies; this will ultimately affect the health and safety of infants and children. Through a joint cooperation, the goal can be fulfilled for all infants to sleep in a safe sleep position and environment.

REFERENCES

1. National Vital Statistics Report. Center for Disease Control and Prevention.

2. Task Force on Sudden Infant Death Syndrome, Moon RY. SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment. Pediatrics. 2011; 128: 1030-1039.

3. Center for Disease Control and Prevention. National vital statistics report.

4. Texas Department of State Health Services. Texas CFRAR.

5. Li DK, Petitti DB, Willinger M, McMahon R, Odouli R, Vu H, et al. Infant sleeping position and the risk of sudden infant death syndrome in California, 1997-2000. Am J Epidemiol. 2003; 157: 446-455.

6. Trachtenberg FL, Haas EA, Kinney HC, Stanley C, Krous HF. Risk factor changes for sudden infant death syndrome after initiation of Back-toSleep campaign. Pediatrics. 2012; 129: 630-638.

7. Safe to Sleep. Public Educational Campaign.

8. Vernacchio L, Corwin MJ, Lesko SM, Vezina RM, Hunt CE, Hoffman HJ, et al. Sleep position of low birth weight infants. Pediatrics. 2003; 111: 633-640.

9. Colson ER, Joslin SC. Changing nursery practice gets inner-city infants in the supine position for sleep. Arch Pediatr Adolesc Med. 2002; 156: 717-720.

10.Gelfer P, Cameron R, Masters K, Kennedy KA. Integrating “Back to Sleep” recommendations into neonatal ICU practice. Pediatrics. 2013; 131: e1264-1270.

11.Shaefer SJ, Herman SE, Frank SJ, Adkins M, Terhaar M. Translating infant safe sleep evidence into nursing practice. J Obstet Gynecol Neonatal Nurs. 2010; 39: 618-626.

12.Hein HA, Pettit SF. Back to sleep: good advice for parents but not for hospitals? Pediatrics. 2001; 107: 537-539.

13.Grazel R, Phalen AG, Polomano RC. Implementation of the American Academy of Pediatrics recommendations to reduce sudden infant death syndrome risk in neonatal intensive care units: An evaluation of nursing knowledge and practice. Adv Neonatal Care. 2010; 10: 332- 342.

14.Aris C, Stevens TP, Lemura C, Lipke B, McMullen S, Côté-Arsenault D, et al. NICU nurses’ knowledge and discharge teaching related to infant sleep position and risk of SIDS. Adv Neonatal Care. 2006; 6: 281-294.

15.Eron NB, Dygert KM, Squillace C, Webster NJ, Andrianos A, Crockett EG, et al. The physician’s role in reducing SIDS. Health Promot Pract. 2011; 12: 370-378.

Gelfer P (2014) Nurses’ Role in Parental Education on Sudden Infant Death Syndrome Risk Reducing Strategies. Ann Nurs Pract 1(1): 1004.

Received : 15 Apr 2014
Accepted : 10 Jun 2014
Published : 12 Jun 2014
Journals
Annals of Otolaryngology and Rhinology
ISSN : 2379-948X
Launched : 2014
JSM Schizophrenia
Launched : 2016
Journal of Nausea
Launched : 2020
JSM Internal Medicine
Launched : 2016
JSM Hepatitis
Launched : 2016
JSM Oro Facial Surgeries
ISSN : 2578-3211
Launched : 2016
Journal of Human Nutrition and Food Science
ISSN : 2333-6706
Launched : 2013
JSM Regenerative Medicine and Bioengineering
ISSN : 2379-0490
Launched : 2013
JSM Spine
ISSN : 2578-3181
Launched : 2016
Archives of Palliative Care
ISSN : 2573-1165
Launched : 2016
JSM Nutritional Disorders
ISSN : 2578-3203
Launched : 2017
Annals of Neurodegenerative Disorders
ISSN : 2476-2032
Launched : 2016
Journal of Fever
ISSN : 2641-7782
Launched : 2017
JSM Bone Marrow Research
ISSN : 2578-3351
Launched : 2016
JSM Mathematics and Statistics
ISSN : 2578-3173
Launched : 2014
Journal of Autoimmunity and Research
ISSN : 2573-1173
Launched : 2014
JSM Arthritis
ISSN : 2475-9155
Launched : 2016
JSM Head and Neck Cancer-Cases and Reviews
ISSN : 2573-1610
Launched : 2016
JSM General Surgery Cases and Images
ISSN : 2573-1564
Launched : 2016
JSM Anatomy and Physiology
ISSN : 2573-1262
Launched : 2016
JSM Dental Surgery
ISSN : 2573-1548
Launched : 2016
Annals of Emergency Surgery
ISSN : 2573-1017
Launched : 2016
Annals of Mens Health and Wellness
ISSN : 2641-7707
Launched : 2017
Journal of Preventive Medicine and Health Care
ISSN : 2576-0084
Launched : 2018
Journal of Chronic Diseases and Management
ISSN : 2573-1300
Launched : 2016
Annals of Vaccines and Immunization
ISSN : 2378-9379
Launched : 2014
JSM Heart Surgery Cases and Images
ISSN : 2578-3157
Launched : 2016
Annals of Reproductive Medicine and Treatment
ISSN : 2573-1092
Launched : 2016
JSM Brain Science
ISSN : 2573-1289
Launched : 2016
JSM Biomarkers
ISSN : 2578-3815
Launched : 2014
JSM Biology
ISSN : 2475-9392
Launched : 2016
Archives of Stem Cell and Research
ISSN : 2578-3580
Launched : 2014
Annals of Clinical and Medical Microbiology
ISSN : 2578-3629
Launched : 2014
JSM Pediatric Surgery
ISSN : 2578-3149
Launched : 2017
Journal of Memory Disorder and Rehabilitation
ISSN : 2578-319X
Launched : 2016
JSM Tropical Medicine and Research
ISSN : 2578-3165
Launched : 2016
JSM Head and Face Medicine
ISSN : 2578-3793
Launched : 2016
JSM Cardiothoracic Surgery
ISSN : 2573-1297
Launched : 2016
JSM Bone and Joint Diseases
ISSN : 2578-3351
Launched : 2017
JSM Bioavailability and Bioequivalence
ISSN : 2641-7812
Launched : 2017
JSM Atherosclerosis
ISSN : 2573-1270
Launched : 2016
Journal of Genitourinary Disorders
ISSN : 2641-7790
Launched : 2017
Journal of Fractures and Sprains
ISSN : 2578-3831
Launched : 2016
Journal of Autism and Epilepsy
ISSN : 2641-7774
Launched : 2016
Annals of Marine Biology and Research
ISSN : 2573-105X
Launched : 2014
JSM Health Education & Primary Health Care
ISSN : 2578-3777
Launched : 2016
JSM Communication Disorders
ISSN : 2578-3807
Launched : 2016
Annals of Musculoskeletal Disorders
ISSN : 2578-3599
Launched : 2016
Annals of Virology and Research
ISSN : 2573-1122
Launched : 2014
JSM Renal Medicine
ISSN : 2573-1637
Launched : 2016
Journal of Muscle Health
ISSN : 2578-3823
Launched : 2016
JSM Genetics and Genomics
ISSN : 2334-1823
Launched : 2013
JSM Anxiety and Depression
ISSN : 2475-9139
Launched : 2016
Clinical Journal of Heart Diseases
ISSN : 2641-7766
Launched : 2016
Annals of Medicinal Chemistry and Research
ISSN : 2378-9336
Launched : 2014
JSM Pain and Management
ISSN : 2578-3378
Launched : 2016
JSM Women's Health
ISSN : 2578-3696
Launched : 2016
Clinical Research in HIV or AIDS
ISSN : 2374-0094
Launched : 2013
Journal of Endocrinology, Diabetes and Obesity
ISSN : 2333-6692
Launched : 2013
Journal of Substance Abuse and Alcoholism
ISSN : 2373-9363
Launched : 2013
JSM Neurosurgery and Spine
ISSN : 2373-9479
Launched : 2013
Journal of Liver and Clinical Research
ISSN : 2379-0830
Launched : 2014
Journal of Drug Design and Research
ISSN : 2379-089X
Launched : 2014
JSM Clinical Oncology and Research
ISSN : 2373-938X
Launched : 2013
JSM Bioinformatics, Genomics and Proteomics
ISSN : 2576-1102
Launched : 2014
JSM Chemistry
ISSN : 2334-1831
Launched : 2013
Journal of Trauma and Care
ISSN : 2573-1246
Launched : 2014
JSM Surgical Oncology and Research
ISSN : 2578-3688
Launched : 2016
Annals of Food Processing and Preservation
ISSN : 2573-1033
Launched : 2016
Journal of Radiology and Radiation Therapy
ISSN : 2333-7095
Launched : 2013
JSM Physical Medicine and Rehabilitation
ISSN : 2578-3572
Launched : 2016
Annals of Clinical Pathology
ISSN : 2373-9282
Launched : 2013
Annals of Cardiovascular Diseases
ISSN : 2641-7731
Launched : 2016
Journal of Behavior
ISSN : 2576-0076
Launched : 2016
Annals of Clinical and Experimental Metabolism
ISSN : 2572-2492
Launched : 2016
Clinical Research in Infectious Diseases
ISSN : 2379-0636
Launched : 2013
JSM Microbiology
ISSN : 2333-6455
Launched : 2013
Journal of Urology and Research
ISSN : 2379-951X
Launched : 2014
Journal of Family Medicine and Community Health
ISSN : 2379-0547
Launched : 2013
Annals of Pregnancy and Care
ISSN : 2578-336X
Launched : 2017
JSM Cell and Developmental Biology
ISSN : 2379-061X
Launched : 2013
Annals of Aquaculture and Research
ISSN : 2379-0881
Launched : 2014
Clinical Research in Pulmonology
ISSN : 2333-6625
Launched : 2013
Journal of Immunology and Clinical Research
ISSN : 2333-6714
Launched : 2013
Annals of Forensic Research and Analysis
ISSN : 2378-9476
Launched : 2014
JSM Biochemistry and Molecular Biology
ISSN : 2333-7109
Launched : 2013
Annals of Breast Cancer Research
ISSN : 2641-7685
Launched : 2016
Annals of Gerontology and Geriatric Research
ISSN : 2378-9409
Launched : 2014
Journal of Sleep Medicine and Disorders
ISSN : 2379-0822
Launched : 2014
JSM Burns and Trauma
ISSN : 2475-9406
Launched : 2016
Chemical Engineering and Process Techniques
ISSN : 2333-6633
Launched : 2013
Annals of Clinical Cytology and Pathology
ISSN : 2475-9430
Launched : 2014
JSM Allergy and Asthma
ISSN : 2573-1254
Launched : 2016
Journal of Neurological Disorders and Stroke
ISSN : 2334-2307
Launched : 2013
Annals of Sports Medicine and Research
ISSN : 2379-0571
Launched : 2014
JSM Sexual Medicine
ISSN : 2578-3718
Launched : 2016
Annals of Vascular Medicine and Research
ISSN : 2378-9344
Launched : 2014
JSM Biotechnology and Biomedical Engineering
ISSN : 2333-7117
Launched : 2013
Journal of Hematology and Transfusion
ISSN : 2333-6684
Launched : 2013
JSM Environmental Science and Ecology
ISSN : 2333-7141
Launched : 2013
Journal of Cardiology and Clinical Research
ISSN : 2333-6676
Launched : 2013
JSM Nanotechnology and Nanomedicine
ISSN : 2334-1815
Launched : 2013
Journal of Ear, Nose and Throat Disorders
ISSN : 2475-9473
Launched : 2016
JSM Ophthalmology
ISSN : 2333-6447
Launched : 2013
Journal of Pharmacology and Clinical Toxicology
ISSN : 2333-7079
Launched : 2013
Annals of Psychiatry and Mental Health
ISSN : 2374-0124
Launched : 2013
Medical Journal of Obstetrics and Gynecology
ISSN : 2333-6439
Launched : 2013
Annals of Pediatrics and Child Health
ISSN : 2373-9312
Launched : 2013
JSM Clinical Pharmaceutics
ISSN : 2379-9498
Launched : 2014
JSM Foot and Ankle
ISSN : 2475-9112
Launched : 2016
JSM Alzheimer's Disease and Related Dementia
ISSN : 2378-9565
Launched : 2014
Journal of Addiction Medicine and Therapy
ISSN : 2333-665X
Launched : 2013
Journal of Veterinary Medicine and Research
ISSN : 2378-931X
Launched : 2013
Annals of Public Health and Research
ISSN : 2378-9328
Launched : 2014
Annals of Orthopedics and Rheumatology
ISSN : 2373-9290
Launched : 2013
Journal of Clinical Nephrology and Research
ISSN : 2379-0652
Launched : 2014
Annals of Community Medicine and Practice
ISSN : 2475-9465
Launched : 2014
Annals of Biometrics and Biostatistics
ISSN : 2374-0116
Launched : 2013
JSM Clinical Case Reports
ISSN : 2373-9819
Launched : 2013
Journal of Cancer Biology and Research
ISSN : 2373-9436
Launched : 2013
Journal of Surgery and Transplantation Science
ISSN : 2379-0911
Launched : 2013
Journal of Dermatology and Clinical Research
ISSN : 2373-9371
Launched : 2013
JSM Gastroenterology and Hepatology
ISSN : 2373-9487
Launched : 2013
JSM Dentistry
ISSN : 2333-7133
Launched : 2013
Author Information X