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Sudden Infant Death Syndrome is, according to the national Sudden Infant Death Syndrome Resource Center, “the sudden death of an infant under 1 year of age which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history” (Willinger et al., 1991:681).

Sometimes called “crib death”, SIDS is sudden, silent, and occurs during sleep. Since most daycare programs and preschools involve naptime, daycare providers and preschool teachers must be aware of SIDS, SIDS risk, and what they can do to prevent SIDS.

SIDS is the leading cause of death in children between one month and one year of age.  In addition, most SIDS deaths happen when babies are between 2 months and 4 months of age.

Is SIDS Caused by Vaccinations?

The Immunization Safety Review Committee which is established by the Institute of Medicine evaluated the evidence of possible causal associations between immunizations that are given in the first year of life and SIDS. These immunizations include Diphtheria-Tetanus-acellular Pertussis (DTaP) vaccine, Haemophilus influenzae type b (Hib) vaccine, Hepatitis B (HepB) vaccine, Inacticated Polio vaccine (IPV), and Pneumococus vaccine (PCV).

The Committee concluded that there is no evidence of a causal relationship between these vaccines and sudden infant death syndrome, sudden unexpected death in infancy, or neonatal death.

How to Reduce the Risk of SIDS in Daycare

While SIDS is not preventable, there are some ways to reduce SIDS risk. The best way to reduce the risk of SIDS in daycare is to develop a safe sleep policy and implement safe sleep practices. The American Pediatric Association’s 2008 publication “A Childcare Provider’s Guide to Safe Sleep” details how to reduce the risk of SIDS in your daycare facility. Some important ways to prevent SIDS:

• Always place babies on their back when they sleep. Even side sleeping is discouraged
• If a parent does not wants his/her child to sleep  on his or her back , Require a physician’s note that explains “why the baby should not use a back-sleeping position, how the child should be placed to sleep, and a time frame that the instructions are to be followed”.
• Infants should be placed on safety approved, firm mattress or with a fitted sheet. Do not place babies on pillows or quilts or other soft surfaces.
• Don’t put soft items in with the bed with the child. This means no soft toys, no loose or extra blankets. Keep any other items away from the child’s face.
• Never allow smoking in a room where babies sleep, as exposure to smoke has been linked to an increased risk of SIDS
• Infants should be dressed appropriately warm. This means light sleepwear so that the infant does not overheat. The NICHD recommends that the room temperature be comfortable for an adult.

• Teach all staff, substitutes, volunteers, and anyone involved in childcare jobs and tasks about safe sleep policies and practices and be sure to review these practices often.

The “Back to Sleep” campaign literature includes a pamphlet titled Safe Sleep for Your Baby: Ten Ways to Reduce the Risk of Sudden Infant Death Syndrome [National Institute of Child Health and Human Development, 2006].

SIDS Organizations

American SIDS Institute

California SIDS Program

National Sudden Infant Death Syndrome Resource Center

Back to Sleep Campaign

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As a child day care center owner, your first order of duty is to keep the children in your care safe. Within the scope of child safety, your daycare business must consider which foods are potentially dangerous to small children. Toddlers are at risk for choking and severe allergic reactions caused by food. Daycare providers must select foods that are healthy and safe for toddlers and avoid those that present potential choking hazards.

Be careful or avoid the following types of hazardous foods for toddlers:

Large chunks of food: Foods for toddlers should be the size of a pea. Anything larger can become lodged in the child’s throat. Make dice large items like hot dogs, carrots, and celery. Soft cook and chop melons and apples. Mash bananas instead of slicing them. Quarter cherry tomatoes, grapes, and strawberries. Shred or chop meat and cheeses into very small pieces.

Peanut butter and other nut butters: Peanut butter causes a choking hazard because it gets stuck to the roof of the mouth and throat and can be hard to swallow. To serve peanut butter to toddlers, avoid serving it in large globs. Instead spread peanut butter thinly on toast or crackers.

Soft, sticky foods: Kids love gummy bears, gum drops, and marshmallows. However, these foods can easily get stuck in a toddler’s throat.

Small, hard foods: Hard, small candies like Skittles, nuts (almonds, peanuts, cashews, etc.), popcorn, raisins, seeds and dried fruit pose a huge choking hazard for small children.

Foods that commonly cause allergies: 4 out of 100 children have a food allergy, according to recent studies by the National Center for Health Statistics. The most common food allergies in young children are caused by cow’s milk, eggs, tree nuts (almonds, pecans, cashews, walnuts, etc.), soybeans, peanuts, and wheat. Be sure to ask parents for complete and thorough information about their child’s allergies including foods to avoid, cross-sensitivities, usual treatment and emergency numbers.

For good measure, avoid the foods on this list of worst foods for toddlers:

• Nuts
• Popcorn
• Chucks of cheese
• Large chunks of raw veggies
• Seeds
• Chewing gum
• Hard candy
• Dollops of peanut butter
• Sticky candy
• Grapes
• Hot dogs
• Large chunks of fruit

Children must always be supervised while eating meals and snacks. Potential child care workers: when applying for childcare jobs, be sure that that you have CPR and First Aid certifications. Child care business owners: Be sure that all staff is CPR and First Aid certified and that that each staff member’s certifications remain current.

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