Developing Partnerships: A Story From Tennessee

Not All Caregivers Follow Safe Sleep Recommendations

Infant safe sleep practices recommended by the American Academy of Pediatrics include placing infants to sleep on their backs and using a firm, flat sleep surface, such as a mattress in a safety-approved crib. Recommendations also include room sharing but not bed sharing and keeping soft objects and loose bedding, such as blankets, out of the infant’s sleep environment. These practices can help reduce the risk of sleep-related infant deaths. However, not all caregivers follow these recommendations.

Determining How to Reach Families

The Tennessee Department of Health (TDH) analyzed their SUID Case Registry data to assess  characteristics associated with sleep-related infant deaths. They found the most common unsafe sleep behaviors included loose bedding or toys in the infant’s sleep area, not using a crib or bassinet, infant sleeping in an adult bed, chair, or sofa with other people, and infant found not sleeping on his or her back. To support families in practicing safe sleep with their infants, TDH worked to reach families in their homes.

Providing Safe Sleep Education and Resources in the Home

In 2018, TDH collaborated with the Evidence Based Home Visiting Program to implement the Safe Sleep Diaper Bag project. The project was expanded to the Community Health Access and Navigation in Tennessee (CHANT) care coordination program in 2019. The goal of these collaborations is to teach all families participating in home visiting or care coordination about safe sleep and provide them necessary resources. Each family receives safe sleep education, a diaper bag with standardized TDH safe sleep messaging, a wearable blanket, and a portable crib if needed. A wearable blanket is a type of sleep clothing that caregivers can use to help keep their baby warm and safe by replacing the caregiver’s perceived need for loose blankets in the crib.

In another effort to reach families in their homes, TDH partnered with Tennessee’s housing authorities to train maintenance workers to recognize an unsafe sleep environment when they go into an apartment. Trained workers are offered access to TDH portable cribs and educational materials that they can provide to families as needed.

A Decrease in SUID Cases

Using their SUID Case Registry data, Tennessee identified a need for increased safe sleep messaging and crib distribution in their communities. Partnering with home visiting and the housing authority allowed them to increase partnerships and expand their reach throughout the state. Tennessee continues to use their data to closely monitor sleep-related deaths and has shown a one-year decline in the number of sleep-related infant deaths since the programs began.

This success story reflects information as reported by the Tennessee SUID and SDY Case Registry.