Welcome to the training on Infant Safe Sleep provided by the Texas Health and Human Services Commission (HHSC) and the Texas Department of State Health Services (DSHS).
Goal
The goal of this module is to equip Texas Health Steps providers and others to recognize risk factors for sleep-related infant death, promote protective factors, and collaborate with parents and caregivers to support safe-sleep practices.
Target Audience
Texas Health Steps providers and other interested health-care professionals.
Specific Learning Objectives
After completing the activities of this module, you will be able to:
- Detect risk factors for sleep-related infant death and promote protective factors to help prevent it.
- Formulate and deliver clear and consistent messages about safe-sleep practices and collaborate with parents and caregivers to support such practices.
NOTE ON TERMINOLOGY: "SUPINE" AND "PRONE"
The medical literature about infant safe sleep often refers to the supine and prone sleeping positions. The American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) use such terminology, as do some other public health advocacy entities. This module also uses supine and prone when referring to the sleep positioning policy and clinical guidance from such organizations.
However, the terms supine and prone can be confusing to new parents and tired caregivers, so it is best to avoid using those words when guiding families about the safest sleeping position for their infant. Say “on the back” instead of supine and “on the tummy” instead of prone.
Remember to keep it simple by saying a baby should always sleep on its back and never on its side, stomach or tummy.
Please note this module expires on 10/3/2022.
This module was released on 10/3/2019.
Accreditation Statement
Continuing Medical Education
The Texas Department of State Health Services, Continuing Education Service is accredited by the Texas Medical Association to provide continuing medical education for physicians.
The Texas Department of State Health Services, Continuing Education Service designates this enduring material for a maximum of 1.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Continuing Nursing Education
The Texas Department of State Health Services, Continuing Education Service is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. The Texas Department of State Health Services, Continuing Education Service has awarded 1.50 contact hour(s) of Continuing Nursing Education.
Social Workers
The Texas Department of State Health Services, Continuing Education Service under sponsor number CS3065 has been approved by the Texas State Board of Social Worker Examiners to offer continuing education contact hours to social workers. The approved status of The Texas Department of State Health Services, Continuing Education Service expires annually on December 31. The Texas Department of State Health Services, Continuing Education Service has awarded 1.50 contact hour(s) of Continuing Social Work Education.
Certificate of Attendance
The Texas Department of State Health Services, Continuing Education Service has designated 1.50 hour(s) for attendance.
Certified Community Health Worker
The Texas Department of State Health Services, Promotor(a)/Community Health Worker Training and Certification Program has certified this course for 1.50 contact hour(s) of continuing education for Certified Community Health Workers and Community Health Worker Instructors.
Disclosures
One of the requirements of continuing education is disclosure of the following information to the learner:
- Notice of requirements for successful completion of continuing education activity. To receive continuing education credit the learner must successfully complete the following activities:
- Create a Texas Health Steps account.
- Complete on-line registration process.
- Thoroughly read the content of the module.
- Complete the on-line examination.
- Complete the evaluation.
- Commercial Support.
The THSTEPS Web-based Continuing Education Series has received no commercial support. - Disclosure of Relevant Financial Relationships.
The THSTEPS Continuing Education Planning Committee and the authors of these modules have no relevant financial relationships to disclose. - Non-Endorsement Statement.
Accredited status does not imply endorsement of any commercial products or services by the Department of State Health Services, Continuing Education Service; Texas Medical Association; or American Nurse Credentialing Center. - Off-Label Use.
Using a disclosure review process, the THSTEPS Continuing Education Planning Committee has examined documents and has concluded that the authors of these modules have not included content that discusses off-label use (use of products for a purpose other than that for which they were approved by the Food and Drug Administration).
The following are policies and definitions of terms related to continuing education disclosure:
The intent of disclosure is to allow Department of State Health Services (DSHS) Continuing Education Service the opportunity to resolve any potential conflicts of interest to assure balance, independence, objectivity and scientific rigor in all of its Continuing Education activities.
All faculty, planners, speakers and authors of Department of State Health Services (DSHS) Continuing Education Service sponsored activities are expected to disclose to the Department of State Health Services (DSHS) Continuing Education Service any relevant financial, relationships with any commercial or personal interest that produces health care goods or services concerned with the content of an educational presentation. Faculty, planners, speakers and authors must also disclose where there are any other potentially biasing relationships of a professional or personal nature.
Glossary of Terms
Conflict of Interest: Circumstances create a conflict of interest when an individual has an opportunity to affect Continuing Education content about products or services of a commercial interest with which she/he has a financial relationship or where there are any other potentially biasing relationships of a professional or personal nature.
Commercial Interest: Any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.
Financial Relationships: Those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, teaching, membership on advisory committees or review panels, board membership, and other activities for which remuneration is received or expected. Relevant financial relationships would include those within the past 12 months of the person involved in the activity and a spouse or partner. Relevant financial relationships of your spouse or partner are those of which you are aware at the time of this disclosure.
Off Label: Using products for a purpose other that that for which it was approved by the Food and Drug Administration (FDA).
Browser Requirements
Texas Health Steps courses are best viewed using a current browser. If you are using an out-of-date browser or a version of Internet Explorer less than 11, lesson progress and interactive features may not function properly.
American Academy of Pediatrics (AAP) Policy Statement: SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleep Environment.
Presents the AAP’s most current guidelines for providing a safe sleep environment for infants with the goal of reducing the risk of all sleep-related infant deaths.
AAP Technical Report: SIDS and Other Sleep-Related Infant Deaths: Evidence Base for 2016 Updated Recommendations for a Safe Infant Sleeping Environment
Provides evidence and rationale behind the AAP’s updated recommendations for a safe infant sleep environment.
AAP's Healthy Children Website
A parent-oriented website that offers parents comprehensive information on safe sleep, addressing common parent concerns such as infant comfort, and videos and short articles about putting baby to bed safely.
Information for Parents of Newborn Children Pamphlet
A resource pamphlet from the Texas Department of State Health Services available in English and Spanish that contains the required information that health-care professionals must provide to pregnant women and to parents at delivery. It includes information about SIDS and current recommendations for infant sleeping conditions.
National Institute for Children's Health Quality's Video: How Safe Sleep Savvy Are You?
A video quiz that engages caregivers in conversations about safe sleep recommendations.
Questions and Answers for Health Care Providers: Sudden Infant Death Syndrome (SIDS) and Other Sleep-Related Causes of Infant Death
This booklet for health care providers answers common questions about SIDS and other sleep-related causes of infant death.
Safe Sleep for Babies: A Community Training
A training manual from the Texas Department of State Health Services designed to be used by service providers of all types for talking with parents, grandparents and caregivers about the best practices for safe infant sleep.
Texas Health Steps Anticipatory Guidance-A Guide for Providers
Age-appropriate anticipatory guidance topics from the Texas Department of State Health Services. For children birth through 20 years of age. Mirrors anticipatory guidance topics included on the Texas Health Steps Child Health Record Forms.
Breastfeeding Resources:
AAP’s Policy Statement: Breastfeeding and the Use of Human Milk
Reaffirms the AAP’s recommendation for mothers to breastfeed exclusively for 6 months and advocates for facilitating breastfeeding practices in hospitals, the workplace, and communities.
Breastmilk Counts Website
Developed by the Texas Department of State Health Services to help families get off to a successful start with breastfeeding.
Ten Steps to Successful Breastfeeding
World Health Organization and UNICEF created the Ten Steps to Successful Breastfeeding to motivate all facilities providing maternity and newborn services to support breastfeeding.
Texas Ten Step Program
The Department of State Health Services (DSHS) in collaboration with the Texas Hospital Association developed the Texas Ten Step Program as a method to improve maternity care practices in birthing facilities.
Culturally Effective Health Care
Healthy Native Babies Project Workbook Packet.
This packet from U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Child Health and Human Development includes the Healthy Native Babies Project Workbook, Healthy Actions for Native Babies Handout, Toolkit disk, and Toolkit User Guide, describes ways to reduce the risk for SIDS among American Indian/Alaska Native babies.
Think Cultural Health website
Think Cultural Health offers many resources, including free, accredited online continuing education programs such as A Physician’s Practical Guide to Culturally Competent Care.
National Initiatives for Infant Safe Sleep:
Association of SIDS and Infant Mortality Programs (ASIP)
Formed with support from the Maternal and Child Health Bureau, ASIP risk reduction or bereavement support for families that have experienced an infant death.
Collaborative Improvement & Innovation Network to Reduce Infant Mortality (IM CoIIN)
A collaboration of public and private agencies, professionals and communities to reduce infant mortality.
First Candle
First Candle’s mission is to reduce the rates of SIDS and SUIDs by educating caregivers and families and supporting research.
The National Action Partnership to Promote Safe Sleep Improvement and Innovation Network (NAPPSS-IIN)
A coalition of more than 70 organizations committed to supporting infant safe sleep and breastfeeding.
Safe to Sleep Public Educational Campaign
Includes strategies for reducing the risk for SIDS and describes actions that parents and caregivers can take to reduce the risk for other sleep-related causes of infant death, such as suffocation.
Swaddling Resources for Parents and Caregivers:
The Benefits of Swaddling Your Baby Video
Information for new parents about how and when to correctly swaddle a baby.
How to Swaddle a Baby Video
A comprehensive online video that demonstrates correct swaddling techniques.
Swaddling: Is It Safe?
Information about swaddling from AAP’s healthychildren.org website.
Safe sleep resources for child-care providers:
AAP's Child Care Provider’s Guide to Safe Sleep
A fact sheet for child care providers that explains the AAP’s recommendations for creating a safe sleep environment.
Texas A&M Agrilife Extension’s Safe Sleep: Reducing the Risk of Sleep-Related Infant Death in Child Care
A free two-hour online training for child-care providers.
Additional Safe sleep resources to share with families:
Baby Safety 101! Video
A video about Safe Sleep for Babies developed for families and caregivers by the organization First Candle.
CDC's Sudden Unexpected Infant Death and Sudden Infant Death Syndrome: Parents and Caregivers Web Page
The CDC’s summary of infant safe sleep recommendations for parents and caregivers.
Infant Sleep Position and SIDS: Questions and Answers for Health Care Providers
A booklet from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) designed for health-care providers to share with parents and caregivers.
Information for Parents of Newborns
Available for download in English or Spanish, page 16 of this pamphlet covers strategies to calm a baby.
Myths and Facts about SIDS and Safe Infant Sleep Web Page
A Safe to Sleep campaign web page with commonly misunderstood facts about SIDS and infant safe sleep.
A Parent’s Guide to Raising Healthy, Happy Children
This guide provides information relating to the development, health, and safety of a child from birth to five, including strategies for calming a crying baby.
A Parents' Guide to Safe Sleep—Helping you to reduce the risk of SIDS
A 2-page fact sheet safe sleep fact sheet for parents summarizing the AAP’s recommendations for infant safe sleep.
The Period of PURPLE Crying
The PURPLE program is designed to help parents of new babies understand the developmental period of infants ages 2 weeks to 3-4 months. It provides education on the normal crying curve, soothing techniques, and the dangers of shaking a baby.
Room to Breathe Website
A safe sleep campaign from the Texas Department of Family and Protective Services available in English and Spanish. The Room to Breathe website provides safe sleep videos for parents and caregivers.
Safe Sleep for Babies Fact Sheet
A fact sheet has been developed in collaboration with the Texas Department of State Health Services and the Texas Department of Family and Protective Services, to increase awareness and educate caregivers on Safe Sleep.
Safe Sleep Checklist
A printable checklist from the Texas Department of State Health Services designed to help parents assess their baby’s sleep environment for safety.
Safe Sleep and Your Baby: How Parents Can Reduce the Risk of SIDS and Suffocation
Safe Sleep for Your Baby is a general outreach brochure available for order from the NICHD. This brochure has also been adapted for African American, American Indian/Alaskan Native, and Spanish-speaking audiences and is available for download as a pdf.
Safe Sleep for Your Baby Video
An online video available in English and Spanish provided by the NICHD.
Safe Sleep for Your Grandbaby: Reduce the Risk of SIDS and Other Sleep-Related Causes of Infant Death
This booklet explains the latest safe sleep recommendations to grandparents and other trusted caregivers so they can help reduce the risk of Sudden Infant Death Syndrome (SIDS) and other sleep-related causes of infant death, such as accidental suffocation. Available for order in English and Spanish.
Someday Starts Now Website
The website features tools for providers in the healthcare and community settings, Life Planning and Birth Planning Tools, videos on the importance of breastfeeding, partner involvement, and preconception health as well as information for men and women of childbearing age for before, during and between pregnancies.
Sweet Dreams: The ABC’s of Safe Sleep Web Page
A Texas Department of Family and Protective Services “Help for Parents. Hope for Kids.” web page that provides quick tips on safe sleep for parents and caregivers.
This single-page handout shows a safe sleep environment for infants and explains ways parents and caregivers can reduce the risks of SIDS and other sleep-related causes of infant death. Available for order in packets of 25.
Helpful Resources
Cribs for Kids
Provides portable cribs and education to families who provide free cribs for families who are unable to purchase a safe crib. Search for a local partner by clicking the website’s “Partners” button.
Materials created by Prevent Child Injury to spread messages on infant safe sleep.
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American Academy of Pediatrics. (2016). Technical Report: SIDS and Other Sleep-Related Infant Deaths: Evidence Base for 2016 Updated Recommendations for a Safe Infant Sleeping Environment. Pediatrics, 138(5): e20162940.
American Academy of Pediatrics. (2016). American Academy of Pediatrics Announces New Safe Sleep Recommendations to Protect Against SIDS video.
American Academy of Pediatrics. (2016). Study: Parents not following safe sleep advice for infants. AAP News, Aug. 15.
American Academy of Pediatrics. (2016). Healthychildren.org, Swaddling: Is it Safe?
American Academy of Pediatrics. (2016). Study: Parents Not Following Safe Sleep Advice for Infants.
American Academy of Pediatrics. (2014). Many Infants Still Not Placed on Their Backs to Sleep.
American Academy of Pediatrics, Committee on Pediatric Workforce. (2015). Enhancing Pediatric Workforce Diversity and Providing Culturally Effective Pediatric Care: Implications for Practice, Education, and Policy Making. Pediatrics, 132(4).
American Academy of Pediatrics. (2012). Policy Statement: Breastfeeding and the Use of Human Milk. Pediatrics, 129 (3) e827-e841.
American Academy of Pediatrics. (2012). A Parent’s Guide to Safe Sleep.
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American Academy of Pediatrics. (n.d.). Safe Sleep Resources.
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Centers for Disease Control and Prevention. (2019). Sudden Unexpected Infant Death and Sudden Infant Death Syndrome: Data and Statistics.
Centers for Disease Control and Prevention. (2018). Beyond the Data—Safe Sleep for Infants Video.
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Children’s Safety Network. (2019). Safe Sleep.
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The medical definitions provided in this module were adapted or obtained from the American Academy of Pediatrics and KidsHealth from Nemours.
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