When Sudden Infant Death Syndrome (SIDS) Occurs In Child Care Settings
This publication is about sudden infant death syndrome (SIDS) in childcare settings. Its purpose is to inform childcare providers about SIDS, to help them cope with a SIDS
death should it happen to an infant in their care. Information the provider can use to help parents, family, and others in the community cope with the consequences of such a
death is also provided. This document is printed with the permission of the National Sudden Infant Death Syndrome Resource Center.
Sudden infant death syndrome (SIDS) is defined as the sudden death of an infant under one year of age which remains unexplained after a thorough case investigation,
including performance of a complete autopsy, examination of the death scene, and review of the clinical history (Willinger, et al., 1991).
SIDS is the leading cause of death in the United States in infants from one month to one year of age. While the majority of deaths occur in the home, some of these deaths
take place while the infant is in the care of someone other than the parents. The loss of an infant to SIDS while in childcare is an especially traumatic event for all
concerned.
It is difficult to find exact figures on the number of SIDS deaths in childcare settings because there are no uniform reporting procedures on infant deaths that occur in
daycare. Labor Force Participation rates for women 15 to 44 years old with newborn children reached the 53 percent level in 1990, up from 38 percent in 1980 and 31
percent in 1976, 1976 being the first year the Census Bureau recorded these statistics (Fertility of American Women: June 1990). These figures have major implications for
childcare providers. It follows that as more mothers return to work and place their infants in daycare, the shift in location of some infant deaths is bound to change.
Childcare providers need to be aware of this change.
"As family daycare providers, we are a special group, we form bonds with other people's children." - Jackie Slade, "A Provider's Greatest Fear: SIDS".
The death of an infant in a daycare setting powerfully affects the family but also stuns the childcare providers. A SIDS death intimately impacts on the providers and their
families as well as on the other children in their care and the parents of these children. Such a crisis situation presents special problems and concerns for all involved and
necessitates a variety of interventions.
It is important to remember that 988 out of 1,000 infants DO NOT die of SIDS and most providers will never experience the death of an infant in their care. However, they
may come in contact with parents, siblings, relatives, friends, or other childcare providers who have been affected by a SIDS death. By understanding SIDS, the intense grief
reaction the long-lasting fears and questions that result, and by acknowledging the need for resources on coping with a SIDS death, the provider can offer assistance and
comfort to others.
Information About SIDS
"An infant's death in a daycare setting requires a variety of interventions. Information and counseling should be available to three groups: the bereaved family, the daycare
provider, and other children at the daycare facility." - Jodi Shaefer, Maryland SIDS Information and Counseling Project, personal correspondence.
Approximately 5,500 to 6,500 babies die each year from sudden infant death syndrome (SIDS), also referred to as crib death. Nobody knows exactly what SIDS is or why is
happens. The death of the baby is sudden and without warning. It occurs in infants of any race, any religion, and any ethnic or economic group. Most deaths from SIDS
take place by the end of the sixth month, with the greatest number occurring in infants between 2 and 4 months of age. More deaths are reported in the fall and winter, and
there is a 60-to-40 percent male-to-female ratio. A death is diagnosed as SIDS only after all other alternatives have been eliminated. The cause of SIDS is still unknown.
Most scientists now believe that babies who die of SIDS are born with one or more conditions that make them especially vulnerable to stresses that occur in the normal life of
an infant, including both internal and external influences. Researchers continue to search for the causes of SIDS, to try to identify infants as risk, and to explain the
psychological impact of SIDS on parents, siblings, the extended family, childcare providers, and others.
The following are some basic facts that are important to understand about SIDS:
SIDS Is:
• a recognized medical disorder listed in the International Classification of Diseases, 9th Revision (ICD-9);
• the major cause of death in infants from one month to one year of age, with most deaths occurring between two and four months;
• currently unpredictable and cannot be prevented, even by a physician;
• determined only after an autopsy, an examination of the death scene, and a review of the clinical history;
• sudden and silent - the infant appears to be healthy prior to death;
• a death that usually occurs quickly and is associated with sleep with no signs of suffering.
SIDS Is Not:
• caused by vomiting and choking, or minor illness;
• caused by the diphtheria, tetanus, and pertussis (DTP) vaccines or other immunizations;
• contagious;
• child abuse;
• the cause of every unexpected infant death.
Sudden Infant Death in Childcare Settings
SIDS occurs at the rate of two deaths per 1,000 live births. With more mothers working outside the home, more infants are being placed with childcare providers and
therefore more SIDS deaths can be expected while the child is under someone else's care. Such a death is an overwhelming tragedy. The death is a blow to the parents
and childcare provider. The loss directly impacts on the baby's parents and family, the provider, and the provider's family. The other children in the facility, their parents,
and the community also are affected. The provider's business may be disrupted for a while.
State laws and jurisdictional regulations vary in the ways investigations of certain types of deaths are carried out. In most cases, a coroner or medical examiner and law
enforcement officers will conduct the inquiry.
This process will include collecting detailed information about the baby's health history, behavior and events prior to the death, the location of the death, and the position of
the infant.
The investigator may take pictures and collect items at the scene of the death. The provider and other adults in the facility will be interviewed, sometimes in great detail,
about the baby and what happened. The state and local childcare licensing agencies also will gather facts for their own inquiries.
In addition, the parents will probably question the provider repeatedly about the last hours of their baby's life. This is a time of intense grief for the childcare provider,
parents, and family members.
"I have yet to get over the feeling that I contributed to this family's loss and grief."- Jackie Slade, "A Provider's Greatest Fear: SIDS"
Common Responses to a SIDS Death - Emotions that parents experience after a SIDS death:
• Guilt - They blame themselves for something they did or did not do. They may blame others. They may feel guilty for things they should have done with the baby. "If
only" becomes a familiar phrase.
• Anger - They feel mild anger to rage. They may be angry with themselves, their spouse, a doctor, or even the baby who died. Intensity of anger causes extreme
anxiety.
• Fear - They fear that something else frightening will happen. They become overprotective of their other children. They may be unwilling or unable to accept their own
roles and responsibilities.
• Depression - They have difficulty concentrating, making decisions, and doing simple things. They often feel despondent, worthless, tired. They may have occasional
thoughts of suicide. They then may become preoccupied with thoughts of the baby.
• Physical Symptoms - Some may experience long periods of crying and appetite disorders. Their arms ache to hold the baby; their insides feel "tied in knots". They
have an urge to escape. They may experience loss of sleep, or they may want to sleep forever.
A Provider's Emotional Response
"It is important to communicate your feelings…your pain, your fears, your sense of helplessness to your family members." - Judith Henslee "The Daycare Worker: Sharing
the Pain of Loss".
Bonding occurs between the baby and the childcare provider, therefore a SIDS death can cause feelings of grief much like those felt by the parents. Because providers
essentially are an extension of the baby's family, the death is a wrenching and emotional event for them as well.
Feelings of anger, loneliness, sadness, guilt, and loss of confidence are common, frequent, and at times unbearable. Other grief reactions include shock, denial,
flashbacks, periods of physical pain or illness, self-doubt, fear of caring for other infants, and depression. Both providers and parents often are dismayed and exhausted by
the depth of these emotions. These feelings are normal, but it is important to note that if they last for an unusual length of time or are extremely severe, professional help
may be needed. Some providers and parents describe feeling numb and as if they were dreaming. Some interpersonal relationships may strengthen and others may
weaken.
The impact of a SIDS loss on the provider's family also can be tremendous. Family members may not be able to understand the depth of suffering because, in most cases,
the childcare provider is the only family member who was close to the baby and the parents. In the case where the provider's own children were present at the time of the
death, the event becomes even more upsetting.
The Impact of SIDS on the Provider, The Family, and The Community
"When a child dies of SIDS while in daycare, the impact can be devastating. Daycare workers involved with the infant may experience an intense grief reaction. For weeks
following the death, the care provider may experience an intense loneliness or sadness whenever anything triggers the memory of the infant."- Judith Henslee, "The Daycare
Worker: Sharing the Pain of Loss"
The provider may have difficulty talking to the baby's parents. Often, the provider was the last person to see the baby alive. The provider had to call the parents and
explain that something was terribly wrong with their child. The provider is usually the one who hands over the baby's belongings to the grieving parents.
The parents' emotions will vary. They may blame the provider for the baby's death but they also could feel guilty and sorry for the provider. Until the results of the
completed investigation identify SIDS as the cause of the death, the parents and the provider spend hours questioning each detail about the baby's death.
When the diagnosis of SIDS is made, the parents and provider should try to accept that no one is to blame and that the death could not have been predicted or prevented.
However, the questioning does not end with the diagnosis of SIDS. The wondering and grieving will continue.
"Caring for a baby brings out feelings of protectiveness and a sense of responsibility in everyone. (When a baby's death occurs) this sense of responsibility leads to
overwhelming guilt."- Ann Kincaid, "Babysitters and SIDS"
Explaining SIDS to Children
One of the hardest tasks following a SIDS tragedy is talking to other children about the death. Explaining death, especially a SIDS death, is difficult. As with any sensitive
subject, there is a balance between being very open and overwhelming the children with information they cannot understand and providing no information at all or even
untruthful explanations. Because many adults have problems dealing with death, they assume that children cannot understand or cope with it. Trying to protect children by
not discussing the death can leave them feeling anxious, confused, and alone.
In the case of a SIDS death, the problem may be greater because other children probably witnessed the dismay of the staff and the panic and disruption created by the
presence of police and emergency personnel. The children could tell something was wrong because of the chaos and confusion.
Both the childcare provider and the parents of the other children at the facility will try to explain what happened. This will take time. Parents of the other children also may
want information and assistance in explaining the death. Help from a professional such as a nurse, community health specialist, or SIDS counselor can make this task
easier. Parents, providers, and other professionals must work together to obtain the best support for each other and for the children.
Two factors influence children's concepts of death: their developmental stages and experiences in life, including their environment, ethnic background, and religion.
Preschool children usually consider death to be reversible, temporary, and impersonal. Children ages five to nine begin to realize that death is final and that living things
die, but they still do not consider death to be personal. As they grow older and reach each developmental stage, they may go over the experience again, seeking more
advanced information. Children ages nine or ten through the teenage years begin to realize that death is irreversible, that all living things die, and that they will die someday.
Children may not show their feelings and may appear unaffected because they are so overwhelmed. It is more common for them to express their reactions through behavior
and play. Regardless of whether they can express themselves openly, children of all ages do grieve, often very deeply. Experts have determined that, much like adults,
children feel afraid, angry, guilty, and sad.
It is very important that people are honest when helping children work through their feelings about death. They should also be able to talk with children who see adults
crying and sad, even when there are no clear explanations. Children often ask questions at the most unexpected times. Answer their questions using words that they can
understand. Children need to feel that talking about the death is an open subject and that they can express their thoughts and questions as they arise. Children should not
be told that the baby "went to sleep forever", or "went on a long trip and will not be back", or other such unfounded explanations. Such simple but dishonest answers only
serve to increase the fear and uncertainty that the child is feeling. Children tend to be very literal and may think that they, too, will die when they go to sleep or on a trip.
"As soon as possible, explain to the other children about the death of the baby - to their parents, as their children have been affected by the tragedy and will need their
support." - Judith Henslee, "The Daycare Worker: Sharing the Pain of Loss"
In helping children to understand and cope with death, remember four key concepts:
• Be loving
• Be accepting
• Be truthful
• Be consistent
Talking to the Parents of the Other Children
Parents of the other children need to be reassured and informed about SIDS. They should be told about the death as soon as possible following the event. SIDS raises fear
in other parents, especially if they also have infants. The other parents should be provided with educational materials and, if desired, the opportunity to speak with
healthcare professionals. Information and counseling after a SIDS death in a childcare setting are needed for everyone.
How Providers Cope After A SIDS Death
The death of a baby in childcare could leave providers hesitant to subject themselves to the possibility of such intense pain in the future. Despite reassurances from the
family, counselors, and healthcare or other professionals, self-esteem and self-confidence may be so low for a while that caring for infants is a problem. Sometimes a
childcare provider will feel so overcome with grief that he or she will leave the profession or prefer to care for older children exclusively for a period of time.
Being informed about SIDS before it happens and receiving support after the death lessens the chances that a provider will leave the childcare profession permanently.
Childcare providers who had cared for a baby when a SIDS death occurred say that accurate information and peer support helped strengthen their resolve to continue in the
profession and to feel confident in caring for other infants.
Even with adequate information about SIDS, it is difficult to accept the fact that no one is to blame. It takes time for the emotions to accept what the mind knows is the truth,
that SIDS is not currently preventable. Support from the parents of the baby who died, as well as from the parents of other children at the facility, is very important. Their
support helps to reaffirm that the provider was not negligent or responsible for the death. Childcare providers should understand that the parents of the baby, parents of
other children in their care, and others might not know how to talk about the death or how to offer support. The parents and others feel just as helpless and inadequate in
the face of such a tragedy as the provider feels.
Support for Childcare Providers
Both parents and providers need support for their grief. Both will experience a wide range of emotions and some traumatic days, weeks, and even months following a SIDS
death. Support is apt to focus on the baby's parents and family, leaving the childcare provider feeling abandoned at a time when help is most needed.
Sharing experiences and feelings with others is healing. Such experiences may be shared with individuals such as the baby's parents (if they seem open to this), public
health nurses, physicians, social workers, ministers, directors of the licensing agency, or the nearest SIDS organization. Attending a bereavement support group may also be
helpful. Talking with other childcare providers who have experienced a SIDS loss and are part of a self-help network may help with the unique problems of a provider.
Regaining confidence in the ability to provide excellent childcare is a basic concept for providers to remember. It is vitally important to understand and believe that no one
was at fault. Education about SIDS is critical to this understanding.
"You will never again be exactly the same person you were prior to the tragedy, but you will have an increased appreciation for the miracle of an infant's life and an increased
awareness of your own inner resources and strengths." - Judith Henslee, "The Daycare Worker: Sharing the Pain of Loss"
This publication is about sudden infant death syndrome (SIDS) in childcare settings. Its purpose is to inform childcare providers about SIDS, to help them cope with a SIDS
death should it happen to an infant in their care. Information the provider can use to help parents, family, and others in the community cope with the consequences of such a
death is also provided. This document is printed with the permission of the National Sudden Infant Death Syndrome Resource Center.
Sudden infant death syndrome (SIDS) is defined as the sudden death of an infant under one year of age which remains unexplained after a thorough case investigation,
including performance of a complete autopsy, examination of the death scene, and review of the clinical history (Willinger, et al., 1991).
SIDS is the leading cause of death in the United States in infants from one month to one year of age. While the majority of deaths occur in the home, some of these deaths
take place while the infant is in the care of someone other than the parents. The loss of an infant to SIDS while in childcare is an especially traumatic event for all
concerned.
It is difficult to find exact figures on the number of SIDS deaths in childcare settings because there are no uniform reporting procedures on infant deaths that occur in
daycare. Labor Force Participation rates for women 15 to 44 years old with newborn children reached the 53 percent level in 1990, up from 38 percent in 1980 and 31
percent in 1976, 1976 being the first year the Census Bureau recorded these statistics (Fertility of American Women: June 1990). These figures have major implications for
childcare providers. It follows that as more mothers return to work and place their infants in daycare, the shift in location of some infant deaths is bound to change.
Childcare providers need to be aware of this change.
"As family daycare providers, we are a special group, we form bonds with other people's children." - Jackie Slade, "A Provider's Greatest Fear: SIDS".
The death of an infant in a daycare setting powerfully affects the family but also stuns the childcare providers. A SIDS death intimately impacts on the providers and their
families as well as on the other children in their care and the parents of these children. Such a crisis situation presents special problems and concerns for all involved and
necessitates a variety of interventions.
It is important to remember that 988 out of 1,000 infants DO NOT die of SIDS and most providers will never experience the death of an infant in their care. However, they
may come in contact with parents, siblings, relatives, friends, or other childcare providers who have been affected by a SIDS death. By understanding SIDS, the intense grief
reaction the long-lasting fears and questions that result, and by acknowledging the need for resources on coping with a SIDS death, the provider can offer assistance and
comfort to others.
Information About SIDS
"An infant's death in a daycare setting requires a variety of interventions. Information and counseling should be available to three groups: the bereaved family, the daycare
provider, and other children at the daycare facility." - Jodi Shaefer, Maryland SIDS Information and Counseling Project, personal correspondence.
Approximately 5,500 to 6,500 babies die each year from sudden infant death syndrome (SIDS), also referred to as crib death. Nobody knows exactly what SIDS is or why is
happens. The death of the baby is sudden and without warning. It occurs in infants of any race, any religion, and any ethnic or economic group. Most deaths from SIDS
take place by the end of the sixth month, with the greatest number occurring in infants between 2 and 4 months of age. More deaths are reported in the fall and winter, and
there is a 60-to-40 percent male-to-female ratio. A death is diagnosed as SIDS only after all other alternatives have been eliminated. The cause of SIDS is still unknown.
Most scientists now believe that babies who die of SIDS are born with one or more conditions that make them especially vulnerable to stresses that occur in the normal life of
an infant, including both internal and external influences. Researchers continue to search for the causes of SIDS, to try to identify infants as risk, and to explain the
psychological impact of SIDS on parents, siblings, the extended family, childcare providers, and others.
The following are some basic facts that are important to understand about SIDS:
SIDS Is:
• a recognized medical disorder listed in the International Classification of Diseases, 9th Revision (ICD-9);
• the major cause of death in infants from one month to one year of age, with most deaths occurring between two and four months;
• currently unpredictable and cannot be prevented, even by a physician;
• determined only after an autopsy, an examination of the death scene, and a review of the clinical history;
• sudden and silent - the infant appears to be healthy prior to death;
• a death that usually occurs quickly and is associated with sleep with no signs of suffering.
SIDS Is Not:
• caused by vomiting and choking, or minor illness;
• caused by the diphtheria, tetanus, and pertussis (DTP) vaccines or other immunizations;
• contagious;
• child abuse;
• the cause of every unexpected infant death.
Sudden Infant Death in Childcare Settings
SIDS occurs at the rate of two deaths per 1,000 live births. With more mothers working outside the home, more infants are being placed with childcare providers and
therefore more SIDS deaths can be expected while the child is under someone else's care. Such a death is an overwhelming tragedy. The death is a blow to the parents
and childcare provider. The loss directly impacts on the baby's parents and family, the provider, and the provider's family. The other children in the facility, their parents,
and the community also are affected. The provider's business may be disrupted for a while.
State laws and jurisdictional regulations vary in the ways investigations of certain types of deaths are carried out. In most cases, a coroner or medical examiner and law
enforcement officers will conduct the inquiry.
This process will include collecting detailed information about the baby's health history, behavior and events prior to the death, the location of the death, and the position of
the infant.
The investigator may take pictures and collect items at the scene of the death. The provider and other adults in the facility will be interviewed, sometimes in great detail,
about the baby and what happened. The state and local childcare licensing agencies also will gather facts for their own inquiries.
In addition, the parents will probably question the provider repeatedly about the last hours of their baby's life. This is a time of intense grief for the childcare provider,
parents, and family members.
"I have yet to get over the feeling that I contributed to this family's loss and grief."- Jackie Slade, "A Provider's Greatest Fear: SIDS"
Common Responses to a SIDS Death - Emotions that parents experience after a SIDS death:
• Guilt - They blame themselves for something they did or did not do. They may blame others. They may feel guilty for things they should have done with the baby. "If
only" becomes a familiar phrase.
• Anger - They feel mild anger to rage. They may be angry with themselves, their spouse, a doctor, or even the baby who died. Intensity of anger causes extreme
anxiety.
• Fear - They fear that something else frightening will happen. They become overprotective of their other children. They may be unwilling or unable to accept their own
roles and responsibilities.
• Depression - They have difficulty concentrating, making decisions, and doing simple things. They often feel despondent, worthless, tired. They may have occasional
thoughts of suicide. They then may become preoccupied with thoughts of the baby.
• Physical Symptoms - Some may experience long periods of crying and appetite disorders. Their arms ache to hold the baby; their insides feel "tied in knots". They
have an urge to escape. They may experience loss of sleep, or they may want to sleep forever.
A Provider's Emotional Response
"It is important to communicate your feelings…your pain, your fears, your sense of helplessness to your family members." - Judith Henslee "The Daycare Worker: Sharing
the Pain of Loss".
Bonding occurs between the baby and the childcare provider, therefore a SIDS death can cause feelings of grief much like those felt by the parents. Because providers
essentially are an extension of the baby's family, the death is a wrenching and emotional event for them as well.
Feelings of anger, loneliness, sadness, guilt, and loss of confidence are common, frequent, and at times unbearable. Other grief reactions include shock, denial,
flashbacks, periods of physical pain or illness, self-doubt, fear of caring for other infants, and depression. Both providers and parents often are dismayed and exhausted by
the depth of these emotions. These feelings are normal, but it is important to note that if they last for an unusual length of time or are extremely severe, professional help
may be needed. Some providers and parents describe feeling numb and as if they were dreaming. Some interpersonal relationships may strengthen and others may
weaken.
The impact of a SIDS loss on the provider's family also can be tremendous. Family members may not be able to understand the depth of suffering because, in most cases,
the childcare provider is the only family member who was close to the baby and the parents. In the case where the provider's own children were present at the time of the
death, the event becomes even more upsetting.
The Impact of SIDS on the Provider, The Family, and The Community
"When a child dies of SIDS while in daycare, the impact can be devastating. Daycare workers involved with the infant may experience an intense grief reaction. For weeks
following the death, the care provider may experience an intense loneliness or sadness whenever anything triggers the memory of the infant."- Judith Henslee, "The Daycare
Worker: Sharing the Pain of Loss"
The provider may have difficulty talking to the baby's parents. Often, the provider was the last person to see the baby alive. The provider had to call the parents and
explain that something was terribly wrong with their child. The provider is usually the one who hands over the baby's belongings to the grieving parents.
The parents' emotions will vary. They may blame the provider for the baby's death but they also could feel guilty and sorry for the provider. Until the results of the
completed investigation identify SIDS as the cause of the death, the parents and the provider spend hours questioning each detail about the baby's death.
When the diagnosis of SIDS is made, the parents and provider should try to accept that no one is to blame and that the death could not have been predicted or prevented.
However, the questioning does not end with the diagnosis of SIDS. The wondering and grieving will continue.
"Caring for a baby brings out feelings of protectiveness and a sense of responsibility in everyone. (When a baby's death occurs) this sense of responsibility leads to
overwhelming guilt."- Ann Kincaid, "Babysitters and SIDS"
Explaining SIDS to Children
One of the hardest tasks following a SIDS tragedy is talking to other children about the death. Explaining death, especially a SIDS death, is difficult. As with any sensitive
subject, there is a balance between being very open and overwhelming the children with information they cannot understand and providing no information at all or even
untruthful explanations. Because many adults have problems dealing with death, they assume that children cannot understand or cope with it. Trying to protect children by
not discussing the death can leave them feeling anxious, confused, and alone.
In the case of a SIDS death, the problem may be greater because other children probably witnessed the dismay of the staff and the panic and disruption created by the
presence of police and emergency personnel. The children could tell something was wrong because of the chaos and confusion.
Both the childcare provider and the parents of the other children at the facility will try to explain what happened. This will take time. Parents of the other children also may
want information and assistance in explaining the death. Help from a professional such as a nurse, community health specialist, or SIDS counselor can make this task
easier. Parents, providers, and other professionals must work together to obtain the best support for each other and for the children.
Two factors influence children's concepts of death: their developmental stages and experiences in life, including their environment, ethnic background, and religion.
Preschool children usually consider death to be reversible, temporary, and impersonal. Children ages five to nine begin to realize that death is final and that living things
die, but they still do not consider death to be personal. As they grow older and reach each developmental stage, they may go over the experience again, seeking more
advanced information. Children ages nine or ten through the teenage years begin to realize that death is irreversible, that all living things die, and that they will die someday.
Children may not show their feelings and may appear unaffected because they are so overwhelmed. It is more common for them to express their reactions through behavior
and play. Regardless of whether they can express themselves openly, children of all ages do grieve, often very deeply. Experts have determined that, much like adults,
children feel afraid, angry, guilty, and sad.
It is very important that people are honest when helping children work through their feelings about death. They should also be able to talk with children who see adults
crying and sad, even when there are no clear explanations. Children often ask questions at the most unexpected times. Answer their questions using words that they can
understand. Children need to feel that talking about the death is an open subject and that they can express their thoughts and questions as they arise. Children should not
be told that the baby "went to sleep forever", or "went on a long trip and will not be back", or other such unfounded explanations. Such simple but dishonest answers only
serve to increase the fear and uncertainty that the child is feeling. Children tend to be very literal and may think that they, too, will die when they go to sleep or on a trip.
"As soon as possible, explain to the other children about the death of the baby - to their parents, as their children have been affected by the tragedy and will need their
support." - Judith Henslee, "The Daycare Worker: Sharing the Pain of Loss"
In helping children to understand and cope with death, remember four key concepts:
• Be loving
• Be accepting
• Be truthful
• Be consistent
Talking to the Parents of the Other Children
Parents of the other children need to be reassured and informed about SIDS. They should be told about the death as soon as possible following the event. SIDS raises fear
in other parents, especially if they also have infants. The other parents should be provided with educational materials and, if desired, the opportunity to speak with
healthcare professionals. Information and counseling after a SIDS death in a childcare setting are needed for everyone.
How Providers Cope After A SIDS Death
The death of a baby in childcare could leave providers hesitant to subject themselves to the possibility of such intense pain in the future. Despite reassurances from the
family, counselors, and healthcare or other professionals, self-esteem and self-confidence may be so low for a while that caring for infants is a problem. Sometimes a
childcare provider will feel so overcome with grief that he or she will leave the profession or prefer to care for older children exclusively for a period of time.
Being informed about SIDS before it happens and receiving support after the death lessens the chances that a provider will leave the childcare profession permanently.
Childcare providers who had cared for a baby when a SIDS death occurred say that accurate information and peer support helped strengthen their resolve to continue in the
profession and to feel confident in caring for other infants.
Even with adequate information about SIDS, it is difficult to accept the fact that no one is to blame. It takes time for the emotions to accept what the mind knows is the truth,
that SIDS is not currently preventable. Support from the parents of the baby who died, as well as from the parents of other children at the facility, is very important. Their
support helps to reaffirm that the provider was not negligent or responsible for the death. Childcare providers should understand that the parents of the baby, parents of
other children in their care, and others might not know how to talk about the death or how to offer support. The parents and others feel just as helpless and inadequate in
the face of such a tragedy as the provider feels.
Support for Childcare Providers
Both parents and providers need support for their grief. Both will experience a wide range of emotions and some traumatic days, weeks, and even months following a SIDS
death. Support is apt to focus on the baby's parents and family, leaving the childcare provider feeling abandoned at a time when help is most needed.
Sharing experiences and feelings with others is healing. Such experiences may be shared with individuals such as the baby's parents (if they seem open to this), public
health nurses, physicians, social workers, ministers, directors of the licensing agency, or the nearest SIDS organization. Attending a bereavement support group may also be
helpful. Talking with other childcare providers who have experienced a SIDS loss and are part of a self-help network may help with the unique problems of a provider.
Regaining confidence in the ability to provide excellent childcare is a basic concept for providers to remember. It is vitally important to understand and believe that no one
was at fault. Education about SIDS is critical to this understanding.
"You will never again be exactly the same person you were prior to the tragedy, but you will have an increased appreciation for the miracle of an infant's life and an increased
awareness of your own inner resources and strengths." - Judith Henslee, "The Daycare Worker: Sharing the Pain of Loss"
Grief Support for Caregivers
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