Targeting parents at risk of sudden infant deaths

Judy Cooper and Camilla Pemberton profile two councils that have enjoyed success in targeting families most at risk of cot death

Lancashire: ‘Awareness in poor areas is key’

Lancashire traditionally had one of the highest numbers of sudden unexpected infant deaths (SUDIs) in the country with six for every 1,000 live births compared with between one and two nationally.

In 2005 the council set about targeting messages to try and reduce this number and had no deaths in the following year.

However, as soon as funding for the project stopped the rate of deaths shot up again. Tina Woods, a Lancashire Specialist Nurse for Sudden Unexpected Death in Childhood, says: “The awareness-raising aspect of the project was clearly really important. So in 2008 the Lancashire Safeguarding Children Board (LSCB) launched a high-profile campaign called the ‘Give me Room to Breathe’ campaign.”.

Hot spots of deprivation

She said deprived communities in Lancashire were identified as hotspots. “In order to engage with families considered hard to reach, we took the message to them. We stood in car parks, supermarkets, parks and pubs to get the information to them. We’d like to target grandparents more as a lot of grandparents look after their grandchildren regularly in Lancashire.”

Woods is one of the nurses who, alongside police, attends to families within 24 hours of a SUDI incident, and says the parents regularly say they were unaware of the risk factors.

Co-sleeping was also identified as a common factor in the SUDIs in Lancashire. Out of 45 sudden infant deaths in Lancashire since September 2008, in 18 of them co-sleeping was a contributing issue.

“We do come across low-income families who say they can’t afford a cot, or who can’t fit a cot into their home or who aren’t prioritising a cot in their budget. We’re looking at this as an organisation to see if there are ways round this. For example, in Manchester they’ve had a pledge from a local charity that if health workers identify needy families without cots, they will provide them.

Co-sleeping risk

“Between December 2008 and June 2009 we had six deaths where co-sleeping was a factor. But we were able to cut this by half for the same period the following year, following the campaign. Ideally, of course, we would like to see no deaths at all – that’s the goal. We could just say, ‘don’t co-sleep’, full stop. But we know people will and we don’t want to force the whole issue underground.”

The Lancashire campaign invested money into creating “useful freebies” for parents including bibs, changing mats and forehead thermometers which were all emblazoned with the campaign messages about risks.

“The forehead thermometers enable parents to check babies’ temperatures and be aware if they are over-heating. They are credit-card sized so they fit in wallets. We tried beer mats but in the current climate people tend to drink at home rather than go to the pub. We also have billboard campaigns, leaflets and posters which we distribute in Sure Start and children’s centres as well as advertisements on local radio and television.”

Enfield: ‘Getting social workers on board’

Nine babies had died from sudden infant death syndrome (Sids), out of 35 in total across London, the first analysis of Enfield’s child death overview panel revealed.

Sally Parma, head of safeguarding and chair of the panel, says the council immediately set about trying to learn lessons from the high number of deaths.

“We found £5,000 funding, part of which was spent on setting up a learning event across Enfield and Haringey for all professionals. We presented our analysis and explored how we could go about trying to prevent these deaths. It was very well attended, particularly by social workers. So much so that social workers have pushed for us to put on a second event so their colleagues can attend.

“We tried to impress upon them that this was everyone’s responsibility from schools and family centres to health, police and children’s services.”

Parma says the one factor that cut across all nine deaths was co-sleeping so they focused their attention on it as a risk factor. Wallet-sized cards for all professionals were produced with the questions they should be asking families on the back.

“We also have now made it part of every social worker’s home-visiting pro-forma to ask where the baby slept the previous night and to see where they slept.”

Parma says they also looked at the geographical location of the deaths and paid for a message about safe sleeping to go on a two-minute loop on public screens in those areas as well as asking people to fill out short questionnaires on what they knew about safe sleeping.

“It can be a delicate area to work in and so we try not to be too authoritarian about it. We simply say to parents that all we can tell them about is the nine deaths that have happened in this area. None of those babies were sleeping in their own cots. We want you to have this information because we would hate for you to suffer the same thing.”

This article is published in the 24 June 2010 edition of Community Care magazine under the headline How Councils Can Reduce Cot Death Rates