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What More Will It Take? – SIDS

What More Will It Take? – SIDS
 

Sadly there is yet another report on the news about a young infant dying in child care. This time it happened in my home state of Iowa in the city of Council Bluffs.

Teresa Chapin, a 37 year old Registered Provider apparently laid five month old Lane Thomas on an adult bed to sleep. According to her statements to the police she laid him down after a feeding and had her daughter check on him during the nap. An hour and a half passed before Teresa realized the child had passed away. Despite efforts to revive the infant, he was pronounced dead shortly after being taken to the hospital.

The specific details of this tragedy are still unfolding so we are left to only speculate on what really happened. An autopsy at the State Medical Examiners in Ankeny Iowa was unable to determine the cause of death. At present, the results state only “Sudden Unexplained Infant Death”. This is not the same as Sudden Infant Death Syndrome.

The provider has been charged with two felony counts including felony neglect of a dependent person and child endangerment. Now two families are devastated and a woman in the prime of her life is facing up to fifteen years in prison.

As I think about this case I am hard pressed to figure out how something like this could happen in this day and age. I can’t imagine making it to the age of 37 and going through the registration process my state requires and not knowing without equivocation what the best practice and minimum standards are for placing an infant under the age of one to sleep.

On page 56 of Iowa’s “Child Development Home Registration Guidelines” it states clearly:
http://www.dhs.state.ia.us/policyanalysis/PolicyManualPages/Manual_Documents/Master/comm143.pdf

As a registered home provider, the Department’s rules require you to place children under the age of one year on their backs to sleep. A physician may prescribe a different sleep position for children with special needs. The National Standards state that all infants must be placed on their backs to sleep unless a physician has prescribed a different sleep position. For naps and nighttime sleeping, infants should:
♦ Be placed on their backs
♦ Be placed on a firm mattress
♦ Be placed in individual infant cribs
♦ Have no soft bedding, pillows, blankets, bumper pads, and stuffed animals in the crib
♦ Sleep at a room temperature of 65-75º F

The regulations even go further in explaining the rationale of why this is a REQUIREMENT:

“Infants who sleep on their backs on a firm surface have a reduced risk of Sudden Infant Death Syndrome (SIDS). SIDS is the sudden and unexpected death of a seemingly healthy infant. SIDS usually occurs between the ages of three weeks and five months. Physicians are still not certain what causes SIDS.

Sleep position and exposure to secondhand smoke are related to SIDS deaths.

REASON: Placing infants to sleep on their backs instead of their stomachs has been associated with a dramatic decrease in deaths from SIDS.”

When we Register we are sent a nearly inch thick envelope including the 113 page Child Development Home packet. We are required to sign that we have read the packet and agree to the standards. The IDHS even goes further in publishing the regulations in an easily searchable format so that providers can access it online and check for any standard changes.

This provider had both the benefit of age, experience, and the excellent information from our state and still made a decision to put this five month old in a sleep position that is dangerously unsafe.

What I’m trying to figure out is WHY she choose an adult bed to nap the baby, why the baby went unchecked by adult eyes for an hour and a half, and why she either didn’t read or disregard our states specific and well researched decisions regarding infant sleep.

When I started caring for kids in my home in 1993 these requirements were not in place. I put every baby to sleep on their bellies, The “best practice” was to have them on their belly to avoid aspiration if they spit up during sleep. I didn’t check them every ten minutes. I believed that babies slept without adults watching them sleep since the beginning of time so having them in child care was no more of a risk then the nights they slept at home while their parents slept. I let babies with reflux sleep in upright infant seats. I didn’t know about positional asphyxia.

When I knew better I did better. I wonder why this provider choose not to.

I don’t know how she came to decide to go against such a specific direction by our state and the plethora of information out there about safe sleep. I do have my suspicions.

When I hear of cases like this the first thing that comes to my mind is that the provider decided to separate the infant because she wanted to get away from crying. Perhaps she was napping other children and wanted to protect their sleep by having a crying infant separate from their area. Protecting their sleep means protecting her precious afternoon break.

I also wonder about space and equipment. Was there ample space in the home to have equipment set up and ready to receive this baby? Does the equipment she uses stand up to repeated set ups and tear downs? Was it easier for her to forgo a separate infant bed because she was using what equipment she DID have the space for to confine the toddlers who would not stay confined unattended?

I’m also curious as to why she had her child check on this child during the nap. What made her allow a child to assess the well being of another child? What was she doing during this baby’s nap that took her away from basic fundamental supervision and delegate it to her daughter?

There HAD to be some reason to make these choices and it most likely had to do with what was easiest and best for the provider at that time. It couldn’t have had a single thing to do with what was best for the baby.

I simply can not believe this provider at the age of 37 did not know about safe sleeping practices. I’ve been in the child care business for 32 years and have watched on the front line the burgeoning research on sleep. I’ve seen hundreds of public service announcements and done thousands of hours of research on infant deaths. When I went into this profession I knew intrinsically that I would have to LEARN the craft. Learning about the care of children is a vast field that takes dedicated research and training. If you do not continually build on your skill set you will have an injury or a death. As you take in children over the years your odds of something going wrong increases. The only way to thwart that is to meet it with more knowledge and better practice.

Another thing I consider when looking at these cases is the providers refusal to accept the fact that caring for other peoples children demands a completely different set of skills and practices than the ones you use while bringing up your own. It isn’t the same as caring for or raising your own children. In fact, there is precious little in common.

You can not do what you want to do when it’s someone else’s kid. You HAVE to abide by your states regulations. You don’t get to take risks with others children like you can with your own. You don’t get to have children that you really can’t care for properly. You don’t get to scrimp on space and protect your time.

I think one great step in preventing this in the future is for our state to separate sleep regulations and have providers provide a written, signed, and even notarized agreement that they will follow the law when caring for babies.

Iowa needs to make a big deal of their sleep regulations by pulling them out of the middle of the other health and safety standards and putting them on a completely separate form that is checked by our Registration Officers when providers register as new and bi-annual registrants. We need to make it perfectly clear that each standard is important but THIS one is of utmost importance. The research and laws are there. We need to do everything in our power to make sure they are understood and applied.

The other suggestion I have is for parents interviewing providers to HAVE the conversation about where the baby will sleep and what sleep practices are being used. Parents and providers NEED to have the discussion about what the provider is to do when the infant cries to the point where it disrupts her ability to stay calm and care for the other kids. They need to talk about SPACE and equipment. Parents need to enforce their expectation that the provider be honest with them if they are unable to provide adequate care and supervision so that different arrangements can be made.

There’s no reason to make a mistake like this in this day and age. There’s no amount of money that is worth loosing the life of a precious newborn and the freedom and family of a caretaker. Whatever her core reasons were for making these poor decisions, I can assure you she would tell you today that not a one of them was worth this outcome.

  1. Maureen10-10-11

    As a provider for 22 years, when I heard about this I thought many of the same things that you mention. While regulations do vary from state to state, the basic regulations of back to sleep with no bedding and SIDS trainings are pretty standard for licensed/regulated providers in all states. The reasons this provider chose to deviate from them are irrelevant now. A child is dead, families are devastated and all providers are reminded that, like it or not, there are rules in place for a reason.

  2. Adina Watkina01-16-12

    I would like to help babysiting and children care too. I am good with kids too. I would like to help u with children and baby and kids too.

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