SIDS: sleeping arrangements

By Prue Salasky,
Damion Taft sleeps peacefully on the cushioned sofa, the occasional smile rippling across his features. His mother scoops up the 2-month-old when she answers the door to greet Tricey Primm, a family support worker from the Newport News Healthy Families Initiative.On this visit, Primm brings with her a Pack 'n Play, a crib substitute donated by the Cribs for Kids program of the Virginia SIDS Alliance to provide a safe place for Damion to sleep.
Inappropriate sleeping arrangements are a contributing factor in the unexplained deaths of 2,500 infants each year to Sudden Infant Death Syndrome, or SIDS. The rate for African-American infants is double those of other ethnicities. Additionally, accidental suffocation, which can result from unsafe sleeping arrangements — such as sleeping with siblings or adults, with stuffed animals, or with ill-fitting bedding — is the leading cause of accidental deaths among infants.Primm has been visiting Uganda Smith twice a month since she was three months pregnant with her first son, Abraham Taft, who turns 3 in October. "She didn't know anything about babies. She realized she needed some help," says Primm, who has books and toys for Abraham to play with during her visit and a handout on nutrition that she leaves with Smith.Abraham outgrew his Pack 'n Play, which got too worn to re-use, and now sleeps either on the sofa, or on a full-size mattress on the floor. Primm advocates for the mattress until they can find him a safe crib or bed. "He could roll off the sofa," she points out.The new Pack 'n Play can safely accommodate his infant brother for up to a year. (There are height and weight restrictions on its safe use.) "You can put it on different levels as a child gets older but it's really only safe for a year. Then we have to look for something else," says Glynda Lowery, team leader for Healthy Families. The city's program enrolls about 140 families at a time, but Lowery also distributes crib substitutes to other low-income Newport News residents through Chesapeake's Sleeptight program. In the latter program recipients must attend a training session on safe sleeping before receiving the portable crib/playpen.When Primm delivers a crib, she has a checklist with pointers on safe sleeping practices — place a baby on its back, no smoking near the baby, no sleeping with siblings or in an adult bed, no pillows — that she goes over with the recipient and has them sign.The SIDS Alliance gives away Pack 'n Play portable cribs rather than full-size cribs for several reasons: Often there's insufficient space in the recipients' homes; full cribs require tools and can be difficult to assemble; and they are subject to recall and can create liability issues. The Pack 'n Play doesn't require any assembly, is safe for sleeping for infants younger than a year — those at the greatest risk for SIDS — and can be used as a playpen.Smith, 37, says she has forgotten a lot since having Abraham. "I'd forgotten all the things you go through in the months you're carrying," she says. She's also concerned about watching Abraham, who is naturally energetic and inquisitive, while looking after Damion at the same time. "He's on his own schedule," she says. Primm has helped her learn about time management, the different stages of development, and how the children grow and interact.She's learned how to cope when Abraham "goes through an emotional state," putting him in time out until they can discuss the problem. Primm also works with the toddler, encouraging him to express his frustrations in a manageable way while teaching him colors and working on his fine motor skills. He'll be screened for preschool at age 3, when he'll be expected to know numbers up to 20, his colors, and more, she explains.All the while Primm offers words of encouragement and advice to Smith. "You like cooking," she urges. "Try making this stew, it has vegetables in it. When he goes to school there'll be different tastes. Introduce him to some different things." Smith nods, saying that she's been trying to get him to eat more vegetables, but he balks at peas and beans. Abraham duly recites the names of the foods he likes.Primm points out the baby acne on Damion's face, but reassures Smith that it will clear up. It's nothing to worry about. Smith says the doctor gave her some cream to use on it.Damion starts to stir. He's hungry. Smith is breastfeeding Damion but supplements with bottles.Primm reminds her gently that she should avoid microwaving the bottle, that it can be too hot, and it's not good with the plastic. Warm it up in water instead, she urges, checking how much Smith's feeding him at one time — just two ounces is fine — and reminding her that milk is all the baby needs at this stage. He weighed less than 6 pounds at birth and now weighs a robust 10 pounds 12 ounces.After burping him, Smith lays Damion gently on his back on a thin mattress cover in the Pack 'n Play, ready for a nap.Virginia SIDS AllianceCribs for Kids program: It works with home visitors to supply portable Graco cribs to needy families when there are no other sleeping arrangements evident and the mother is within six weeks of delivering, or the baby is less than 1 year old. The donated cribs, which cost the alliance $55 plus $8 shipping, are set up at the home at no cost and a parent/guardian must sign a waiver after being instructed in safe sleeping practices. This year, the alliance will donate 250 cribs. There is currently a waiting list for cribs.
http://www.dailypress.com/features/family/dp-nws-crib-delivery-20100823,0,6888255.story