Sleeping Safely: Philadelphia

As the National Health Corps Cribs for Kids Advocate at the Maternity Care Coalition my main tasks are to schedule and educate community members about safe sleep for infants. Clients of the Maternity Care Coalition’s Cribs for Kids program range from 32 weeks pregnant to up to 1 year postpartum as long as their child is under 30 pounds.The safe sleep education that clients receive goes over numerous lifestyle practices that can be used by parents to ensure their child is sleeping in a safe environment to reduce the child’s risk of sudden infant death syndrome (SIDS). Topics covered in the safe sleep education include:

● safe/unsafe places for the infant to sleep - infants should always sleep in a crib, bassinet, or Pack N Play (PNP). It is ok for the infant to fall asleep in a stroller or car seat for a short amount of time, but the baby should be placed in a PNP or other approved sleep space when available. Infants should never sleep on anything cushiony (such as a bed, sofa, boppy pillow).

Graco Pack N Play Crib with bassinet portion (maternitycarecoalition.org)

● appropriate objects to be in the Pack N Play with the child - the only other objects that should be in the PNP with the infant are a pacifier and a receiving blanket or sleep sack.

Examples of unsafe and safe sleeping environments (maternitycarecoalition.org)
● infants sleeping on their back - placing the infant to sleep on it’s back has been shown to reduce the risk of SIDS the greatest.

● the dangers of overheating infants - infants should never sleep with a hat on. Hats can trap body heat, which mostly escapes through the head, and overheat the baby. In the winter a receiving blanket or sleep sack should be used with a long-sleeve onesie to prevent over-bundling.

● encouraging breastfeeding - there are a multitude of benefits for breastfeeding for mom and for the baby. Breastfeeding helps improve the infant's immunity and reduces the risk of SIDS, can help the mother lose the baby weight, and reduces the mother’s risk of ovarian and breast
cancer.

● tummy time - by supervising an alert infant on their stomach, the infant’s neck, back, and arm muscles can develop, allowing the baby to hit developmental milestones such as sitting, walking, and crawling. Tummy time can start as soon as the baby’s umbilical cord falls off.

● pacifier use - begin pacifier use between 4-6 weeks after birth to prevent confusion between the pacifier and breastfeeding. Infants should be weaned off pacifiers at one year to prevent later problems with teeth alignment.

● 3rd hand smoke - not only do you not want to smoke around an infant, you also do not want to  smoke around an infant’s sleep environment. This is because the smoke particles can settle into  the mattress and sheets, and then the baby can breathe in those smoke particles, which can be harmful to the infant’s lungs.

● well baby visits - client’s should attend all well baby visits and vaccinations have been shown to reduce the risk of SIDS. It is wise to invest in a small notebook so that parents can keep track of what goes on at each appointment and also write down questions they want to ask the doctor between visits.

● room sharing - the baby’s safe sleep environment (crib/bassinet/PNP) should be kept in the parent’s room for the first 6 months because this is when the infant is at it’s highest risk for SIDS.

The scheduling of clients is done over the phone or in the case of a non-English speaking client, through a social service provider. There are a number of ways clients can find out about our services which include calling the hotline number, filling out a crib request form online through the Maternity Care Coalition’s website, or havinga referral form faxed to the company from a social service provider. Clients who are within 8 weeks of their due date (or postpartum), live within a Philadelphia zip code or accepted zip codes in Delaware county, and receive some form of public benefits qualify for the services offered through the program.

Safe sleep education is provided through three methods: workshops, office visits, or home visits. Workshops are an interactive, group learning experience that occur in four different locations throughout the city once a month. Workshops rely on clients interacting with the facilitators and with each other to determine safe and unsafe spaces for babies to sleep, and what is ok or not ok to have in a PNP with a sleeping child. Home visits are conducted twice a week, once in the north and once in the south areas of the city. These visits  are reserved for clients who have trouble speaking English and clients whose infants are home without a safe sleep environment. When we conduct home visits the program sets up the PNP for the clients, sends in the registration card, and does one-on-one safe sleep education with a picture flip book and translated materials (if necessary). Office visits are utilized for prenatal or postpartum clients who cannot attend a workshop due to their own conflicts (i.e. doctors appointments, transportation).

The Cribs for Kids program has a fairly vast impact on families within the Philadelphia and Delaware counties, serving 3,307 clients and giving away 2,705 PNPs in the past year. That is an average of 7 families receiving a safe sleep environment and education per day, every day for one year.

Overall, serving as a part of the Cribs for Kids team this service term has been highly rewarding. It is such a wonderful experience to be able to assist our clients in a meaningful way during one of the happiest times of their lives, the birth of a child. The gratitude expressed from our clients validates the efforts put forth by the team to contact, schedule, and educate our clients about how to reduce their child’s risk for SIDS. Educating our clients about safe sleep practices and the Maternity Care Coalition’s services also helps disseminate the knowledge we provide to our clients throughout the community, thus spreading safe sleep awareness throughout Philadelphia.
 

This blog post was written by NHC Philadelphia member Kelly Carey.
Kelly serves as the Cribs for Kids Advocate at Maternity Care Coalition.