What we have achieved in Victoria…

• Emergency response

• Policy

• Increase number of presentations and reach average of 3000 health professionals per year

• Childcare educators• Child protection • Family Services• Maternity Services• Foster carers• Indigenous health workers and CALD groups• Pharmacists/retail• Representation re nursery products ACCC/Consumer Affairs• Maternal Child Health Nurses

Majority of SUDI occurring in Victoria had at least one modifiable risk factor

Provide a safe sleeping environment night and day

Parents and health professionals are either unaware, do not understand, or choose to ignore the Safe Sleeping recommendations

Sharing a Sleep Surface

The Victorian coroner recently made recommendations based on his findings following investigation of the cases of four Victorian babies who died in 2009 and 2010 who shared a sleep surface with another person usually an adult care giver.

The Coroners Prevention Unit examined a total of 72 infant deaths occurring in a sleeping context over a three year period. It found that 33 of these deaths occurred whilst the infant was sharing a sleep surface with another person (Bugeja et al. 2011).

A statistically significant association was identified for infants less than four months and the presence of a pillow with deaths occurring in a co-sleeping context.

• The coroner recommended on current evidence that the safest place for an infant to sleep is on their back on a separate sleep surface in a safe cot in the same room as a caregiver for the first six to 12 months of life.

• The coroner further recommended that consistent and evidence-based messages be given to parents about safe sleep practices for infants by health professionals, and that policy be in alignment with the SIDS and Kids information statement ‘Sleeping with a baby’

•Consistent, clear, evidence-based messages to be given

•Policy to be implemented and on going education

•Create stronger and supportive environments for all professionals

•Victorian infants slept in safe sleeping environments

•Government support to sustain our work and growth

Resources?Where to from here…

Definitions

CO-SLEEPING=Being asleep on the same sleep surface as the baby (UNICEF)

BEDSHARING=Bringing baby onto a sleep surface when co-

sleeping is possible, whether intended or not (UNICEF) Roomsharing

Sharing the same sleep surface

Why is room sharing protective against sudden and unexpected infant death?

• facilitates a rapid response to a baby’s needs, more convenient settling ,comforting of babies, and closer mother-baby contact and communication

•increased adult supervision and observation of the baby•Studies of nighttime mother-baby interactions have demonstrated that compared to mothers who sleep apart from their babies, babies and mothers who sleep in close proximity demonstrate increased physical contact, more breastfeeding episodes and increased arousals

Benefits of Bed sharing/Roomsharing(Blair 2010)

Physiological benefits• mother/infant contact=>increases infants skin temp, stabilises

heart temp, reduces crying, increases milk productionPsychological and Emotional benefits• Increased self esteem later in life• Less psychiatric problems• Improved cognitive performance

• Impact on breastfeeding probably biggest concern if discouraging bed sharing

“…may conceivably reduce SIDS(SUDI) rates even further but not necessarily infant mortality in general.”

Bed-sharingIs there a significant risk?

ANSWER

• More SIDS infants are found in the parental bed than expected

• Additional increase in number of co-sleeping deaths on sofas and chairs

• Proportion of bed sharing deaths within SUDI appears to have risen dramatically although actual number of SIDS has decreased

Co-sleepingDo we understand the nature of the risk?

ANSWER;

Some researchers state• Not bed sharing that is dangerous, but instead the

particular circumstances in which bed sharing occurs that is dangerous

• Infant care practices that parents who bed share exhibit:

An Unsupervised Adult Bed May Be Unsafe For Babies Or Toddlers

Risks increased if co sleeping with other children or

unrelated carers or pets

•Co-sleeping on sofas,

•Risks increased when co-sleeping with an adult is a smoker

•Covering of infants face and head Use of doonas, loose bedding, pillows, sheepskin underlays

•CO2 rebreathing

•Thermal stress

What are the risks?