N.B. to develop awareness campaign about unsafe sleep situations for infants

The New Brunswick government plans to roll out a public awareness campaign this spring about the risks of unsafe sleeping environments for infants, including bed-sharing and inappropriate sleep surfaces.

But the details are still being worked out, said Department of Health spokesman Paul Bradley.

"We are currently developing a plan for the awareness campaign and exploring the associated costs which will depend on the final tactics chosen," he said in an emailed statement Thursday.

The department is "exploring several options," including social media or radio advertisements, to "improve the reach of the safe sleeping message to residents," he said.

It is apparent that the printed literature is not having the desired effect in preventing child deaths of this nature.- Child death review committee

The province's child death review committee recommended on Feb. 15 that the acting chief medical officer of health consider developing a campaign to educate the public about the issue, following the accidental death of a three-month old boy.

The infant's cause of death was deemed to be likely asphyxia due to an "unsafe sleep situation." No details about what made his sleeping situation unsafe have been released.

He is at least the third child in the province to die as a result of "an unsafe sleep situation" since 2014.

"It is apparent that the printed literature is not having the desired effect in preventing child deaths of this nature," the committee said, suggesting a new campaign might include television and/or radio advertisements.

Best practices reviewed

Dr. Jennifer Russell, the acting chief medical officer of health, issued a statement earlier this week, thanking the committee for its work and accepting its recommendation.

"Every child has a right to a safe and healthy environment," she said. "It is important for parents and caregivers to be informed of the risks associated with unsafe sleep practices for infants, to have access to information and are supported in efforts to protect and prevent harm."

Department officials have reviewed what documentation exists in other jurisdictions, which will assist in developing material "best suited for New Brunswick," said Bradley, without elaborating.

They also plan to consult with the Office of the Child and Youth advocate, he said.

This isn't the first time the child death review committee has made recommendations about unsafe sleeping arrangements for infants and children.

In 2014, the committee recommended hospital staff talk to new parents about the dangers of bed-sharing before taking their newborn home.

The committee also called for social workers to reinforce the dangers of unsafe sleep surfaces, such as couches.

That same year, then-Social Development Minister Madeleine Dubé said social workers would reinforce the message with their clients and child protection standards were updated to make sure social workers review where children are sleeping.

While some information about unsafe sleeping environments is already available in New Brunswick and nationally, "our hope is that by highlighting this issue through an awareness campaign we will increase awareness of the associated risks," said Bradley.

Support for multimedia approach

Jessica Webster, a perinatal registered nurse and senior instructor at the UNB Fredericton's faculty of nursing, is hopeful a multimedia-style campaign will help.

It will offer important reminders for new parents and help reach other caregivers as well, such as extended family members and babysitters, she said.

Continued messages on an ongoing basis will help reinforce those key messages and hopefully continue to influence practices.- Jessica Webster, perinatal nurse and instructor

As it stands, all new parents in New Brunswick receive in-hospital bedside teaching about safe sleep practices, such as using "co-sleeping", where the baby's crib is within arm's reach of the bed, as opposed to bed-sharing, said Webster. The crib's mattress should be firm and there should not be any bumper pads, pillows or plush toys.

Parents also receive a set of books, called Loving Care, to take home, which detail safe sleep environments and how to avoid the risks of sudden infant death syndrome (SIDS), also known as crib death.

"But it seems that perhaps that approach to teaching new parents is not the most effective as we are continuing to see unsafe sleeping practices for many young families," said Webster.

Part of the problem, she said, could be that new parents receive "quite a bit of information in a short period of time, which may very well be overwhelming for some."

Some parents might forget some of the information, or the "weight of the message" gets lost. "They may start to feel a false sense of security or comfort" as the days pass, even though the risks of suffocation continue for at least the first year.

Other parents may be well-intentioned but sleep-deprived, said Webster, citing a 2016 study in the United States, which found about 90 per cent of parents placed their babies in sleep environments they knew were associated with increased risks of death.

Sleep-deprived parents

For the study, Nocturnal Video Assessment of Infant Sleep Environments, researchers video-recorded 167 infants in the family homes at the ages of one, three and six months.

Most parents, even when aware of being recorded, placed their infants in environments with established risk factors for sleep-related infant deaths, including positioning the children on their sides or stomachs, soft sleep surfaces, loose bedding, or bed-sharing, the study found.

Infants who were moved in the middle of the night were more likely to be placed in a sleep environment that posed hazards.

"So the more this is brought into conversation and the more it is addressed in public forums, the better," said Webster.

"Continued messages on an ongoing basis will help reinforce those key messages and hopefully continue to influence practices."