A change to the way safer sleep information is communicated is needed if the risks to children from unsafe sleep practices are to be reduced, according to a new report from the universities of Oxford, University College London, Bristol and Newcastle. This was made by the government, on the heels of sudden death in childhood data, in an effort to determine what kind of support is needed to reduce infection in all families
Today’s report on promoting safer sleep for children has a particular focus on families facing significant adversity, who may receive support from children’s social care services.
While rates of sudden unexpected death in children (SUDI) fell sharply in the 1990s and continued to decline through 2014, families living in the most disadvantaged neighborhoods continued to experience a disproportionately higher rate; The National Child Mortality Database found that 42% of SUDIs occurred in disadvantaged neighborhoods, compared to 8% in the least deprived.
Researchers interviewed parents, spoke to local career services, and studied data on safer decision-making and sleep interventions.
The findings of this research suggest that it may be beneficial for practitioners who work to promote safe sleep practices with parents facing a range of adverse life circumstances, some of whom may also have a social worker, to focus on exploration openly and honestly. Reasons why parents, for example, should sleep with a baby, and how to do so safely.
While this is consistent with national guidance on safe infant sleep practice, it represents a less didactic approach to working with these families, and relies on developing a relationship of trust between parent and practitioner.
Jane Barlow is Professor of Evidence-Based Intervention and Policy Evaluation in the Department of Social Policy and Intervention at Oxford
According to the report, a range of motivational factors play a major role in influencing decision-making about an infant’s sleep environment, including parents’ own needs for adequate sleep, and the need to bond with their babies. Research also indicates that professionals responsible for conversations about infant sleep safety have concerns about providing personalized support and risk management in families with a social worker.
The researchers recommend the following:
- Open conversations between parents and professionals can be used to support safer sleep for children who have a social worker.
- These open conversations will need to acknowledge and discuss the realities of people’s lives in order to understand and address the motivation behind parents’ decisions and actions.
- Conversations should include trusted, trusted sources and sound evidence to explain how and why safer sleep practices aim to protect children. Social pressures regarding “good parenting” may act as barriers to open and frank conversations between parents and professionals.
Dr Anna Pace, Research Fellow at Bristol University Bristol Medical School, said: “Families have a right to evidence-based information on how to reduce the risk of their child’s sudden death. We know that safer sleep advice in general has saved thousands of children’s lives. But this approach has not been effective for families with children who are more at risk.This research really shows how we need to focus on supporting those families who need extra support: tailoring messages to their circumstances, working with the caregiver’s own motivations and instincts, and making sure that these The messages come from trusted and reliable support sources.
The research has found that in-depth conversations about safer sleep may be best offered to families receiving social care by a practitioner, such as a health visitor, who can provide continuity of care and who has established a relationship of trust with them. Peer and family support networks are also important to reinforce messages and provide practical advice.
The report notes that professionals can engage parents to identify triggers and provide personalized support that remains consistent with national guidance, but that this depends on the needs of individual families.
This is likely to require special training and support for professionals and a change in organizational culture to allow professionals to manage risk more confidently. Such conversations should be consistent with guidance from NICE and the Lullaby Trust taking into account the needs and context of individual families.
