Reducción de Riesgos del SIDS

Presentación del tema: "Reducción de Riesgos del SIDS"— Transcripción de la presentación:

1 Reducción de Riesgos del SIDS
Guías de la Academia Americana de Pediatría y la Directiva OCDC del uso de las cobijas

2 Realidades acerca del SIDS
SIDS es la muerte inesperada de bebés de 12 meses o menores, que parecen estar sanos Las causas exactas del SIDS no se conocen Los expertos no pueden predecir bebés SIDS Aproximadamente 20% de las muertes SIDS ocurren mientras los bebés se encuentran en un lugar de cuidado de niños Provide the definition of SIDS as defined by Willinger, James, and Catz in Pediatric Pathology to use as a basis for the rest of the presentation. Definition: The sudden death of an infant under 1 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. SIDS is a diagnosis of exclusion. This means that all other possible causes of death are ruled out before a SIDS diagnosis is applied. A SIDS diagnosis takes into account autopsy findings, results of the investigation of the place where the baby died, and a review of the baby’s medical history. Sometimes the family’s health history also is reviewed. Unfortunately, experts are not able to predict which babies will die from SIDS. Willinger M, James LS, Catz C. Defining the sudden infant death syndrome (SIDS): deliberations of an expert panel convened by the National Institute of Child Health and Human Development. Pediatr Pathol. 1991;11:677–684 2

3 Realidades acerca del SIDS
En 2000, hubo aproximadamente 2,500 casos SIDS (en los Estados Unidos) Causa principal del fallecimiento de bebés de 1 a 12 meses de edad La cifra más alta está de 2 a 4 meses; 91% ocurrieron entre 1 y 6 meses de edad. Más fallecimientos SIDS ocurren en los meses de invierno Más bebés varoncitos mueren de SIDS These SIDS facts are based on years of national data that show which, when, where, at what age, and under what circumstance babies die suddenly and unexpectedly. Data are derived from the National Institute of Child Health and Human Development and SIDS researchers. SIDS is The cause of death for approximately 2,500 babies in the US (in 2000). The leading cause of infant death between 1 and 12 months of age. The third leading cause of infant death from birth to 1 month of age—before month, babies are dying of other causes (no. 1, low birth weight and preterm birth; no. 2, birth defects). (This fact is not on the slide but augments fact on infant death between 1 and 12 months of age.) Most prevalent among infants who are 2 to 4 months old. More prevalent during the winter months (November–March). More prevalent in male babies than female babies. SIDS risk increases as much as 18-fold when an infant is accustomed to sleeping on the back and is then placed on the tummy to sleep in the care of a person that is not the primary caregiver. Revised 10

4 Normas de Ejecución HS y Regulaciones CCD
(b)(3) Para reducir el riesgo del Sídrome de Muerte Infantil Repentina (SIDS por sus siglas en ingles), todas las dispocisiones para dormir para los bebés deben tener colchones firmes y evitar materiales suaves, tales como edredones, cobijas mullidas o monos de peluche. (6) Los bebés deber ser colocados sobre sus espaldas para dormir

5 Regulaciones CCD --Cunas
(7) Las cunas, las cunas portátiles y los corralitos y las sillas altas deben cumplir con las Normas de la Comisión de Seguridad de Productos al Consumidor u otras normas equivalentes. (1) Cada bebé debe tener una cuna, una cuna portátil o corralito con un colchón limpio no absorbente que cumpla con los siguientes requisitos: (a) Cada cuna debe ser de construcción sólida con barandales verticales a no más de 2 3/8” de distancia; (b) Los seguros y las aldabas del barandal movible de la cuna deben ser seguros y asegurarse que no se abran accidental o los abran los bebés que están dentro de las cunas; (c) Las cunas no se deben usar con el barandal bajado; (d) Los colchones deben quedar ajustados;  (e) Cada colchón debe estar cubierto con una sábana;  (f) Si se usan protectores en las cunas, estos se deben poder limpiar fácilmente y no ser peligrosos para los niños; (g) No se debe tener ni usar ningún tipo de adminículo de restricción a menos que lo prescriba un médico; y (h) No se usará emparedar o apilar las cunas (2) Otros arreglos para dormir que no sean cunas, cunas portátiles o corralitos, deben ser aprobados por CCD.

6 Guías AAP para Centros de Cuidado de Niños
Acueste a dormir a los bebés sobre sus espaldas, a menos que el proveedor médico indique lo contrario Coloque a los bebés boca-arriba, pero permita que se volteen cuando lo pueden hacer. De pancita para jugar y de espaldas para dormir. Use precauciones de seguridad para dormir Proporcione un entorno seguro para dormir When implementing a new practice in child care, Caring for Our Children: National Health and Safety Performance Standards: Guidelines for Out-of-Home Child Care Programs, Second Edition, should be consulted. The national standard on sleep positioning is consistent with and incorporates the standards recommended by the AAP, SIDS Resource Center, and National Resource Center for Health and Safety in Child Care. A copy of the entire publication is available online at nrc.uchsc.edu/CFOC. The standards for sleep, cribs, and bedding are designed to reduce the risk of SIDS and promote children’s health and safety while they are in child care. An abbreviated text addressing SIDS and sleep conditions is available online at nrc.uchsc.edu/SPINOFF/SIDS/SIDS.htm. 20

7 De Pancita para Jugar y de Espaldas para Dormir
Tiempo supervisado cuando los bebés están despiertos sobre su pancita. Promueve el desarrollo físico y mental sano Fortalece los músculos del cuello, los brazos y los hombros De espaldas para dormir Reduce el riesgo del SIDS Confortable y seguro It is important for an infant’s development to have supervised tummy time. Tummy time is supervised playtime with the child while he or she is positioned on the tummy. By incorporating tummy time every day, we are able to address some of the barriers to placing babies to sleep on their backs, such as flat head and the ability to roll over and sit up. By making sure that babies have supervised tummy time, you are promoting healthy physical development, the opportunity to learn to lift and turn their heads and exercise their bodies, and time to strengthen the neck, arm, and shoulder muscles. This will help to ensure that the baby will reach its developmental milestones of rolling over and sitting up at the recommended time. Tummy time also promotes brain development by developing the muscle capacity and gaining increasing control of the upper body. This enables babies to be better able to turn their heads in response to sound, thus increasing their ability to explore their world as they begin to connect sight and sound. During tummy time, be sure to keep a watchful eye on babies. Remember, by placing babies on their backs to sleep, you are reducing the risk of SIDS. Don’t worry, back sleeping is comfortable and does not require any special equipment. Wedges to keep babies in place are not necessary and are not recommended, unless specified by a physician. Tummy time for awake babies and back to sleep promotes the infant’s development and safety, including lowering the risk of SIDS. 22

8 Medidas Seguras para Dormir
Acueste siempre a los bebés sanos a tomar la siesta o a dormir sobre sus espaldas. Evite tenerlos demasiado calientes Nunca cubra la cabeza del bebé con una cobija La temperatura del cuarto debe ser confortable para un adulto vestido con ropa ligera No les ponga demasiada ropa No ponga más de un bebé en la cuna This slide is self-explanatory and may be read by the presenter. Be consistent—Always put healthy babies to sleep on their backs for naps and at bedtime. It is important to consistently use the back sleep position for babies regardless of the caregiver. If a baby is accustomed to sleeping on the back at night, he or she should continue to be placed on the back for naps. The risk of SIDS dramatically increases when a baby, unaccustomed to sleeping on the tummy, is switched from the back to the tummy. Avoid overheating. At an early age, babies are unable to regulate their own body temperature. Over time their ability to regulate body temperature and other internal comfort controls increases. Becoming too hot can diminish the baby’s ability to maintain its core body temperature. Signs that the baby is too hot include sweating, damp hair, flushed cheeks, heat rash, and breathing rapidly. A good rule of thumb is to dress the baby the way you would like to be dressed to sleep. Room temperature should be comfortable for a lightly clothed adult. (Continued on next slide) Revised 23a

9 Entorno Seguro para Dormir
Cuna que cumple con las normas de seguridad Colchón firme que queda ajustado en la cuna Se evitan las sillas, sofás, camas de agua y camas de adulto No se excede la ropa de cama, edredones o cojines No se recomienda usar protectores o cuñas alrededor de la cuna No juguetes o animales de peluche en la cuna Cobijas metidas a lo largo y al pie del colchón The safest place for a sleeping baby is on his or her back in a safety-approved crib that is free of excess bedding and stuffed animals. The baby should sleep in a place that does not have secondhand cigarette smoke. Safety-approved crib, firm mattress. The crib should be safety approved with slats spaced not more than 23/8" apart. The firm mattress should be a snug fit for the crib, portable crib, or playpen frame. The space between the mattress edge and crib frame should not be more than the width of 2 adult-sized fingers, and the mattress should have a tight-fitting sheet. Avoid chairs, sofas, water beds, and adult beds. It is best practice to not put babies to sleep anywhere but in a safety-approved crib. In family child care home settings, it is not uncommon to find babies sleeping on a variety of surfaces. Chairs, sofas, water beds, cushions, and standard or adult beds are NOT safe sleep surfaces because babies can fall or become entrapped in crevices in the furniture or between cushions. No excess bedding, comforters, or pillows. Excess bedding and fluffy blankets, comforters, and pillows can impair the baby’s ability to breathe if these items cover the face. Toys and stuffed animals as well as bumper pads and wedges should not be placed in the crib. The crib should be placed in a smoke-free environment. Revised 26

10 Ambiente Seguro para Dormir
Quitarles el babero y demás artículos restrictivos antes de acostar a dormir a los bebés Mantener un ambiente libre de humo Sacarle apropiadamente el aire a los bebés durante la comida y antes de acostarlos a dormir Observar cada 15 minutos a los bebés que están durmiendo

11 Beneficios del Ambiente Seguro
Salva la vida de los bebés Le muestra a los padres que la salud y la seguridad tienen una alta prioridad Educa al personal Educa a los padres Reduce los riesgos de responsabilidad civil The baby and child care provider benefit when a safe sleep policy is in place. A child care provider will feel relieved knowing that the practice of putting a baby on its back to sleep is supported by a written safe sleep policy, even if the parents do not perform this same practice at home. There are many benefits to having a safe sleep policy. It has the potential to save baby’s life. It shows parents that their baby’s health and safety is your number one priority. It educates staff – By ensuring that all child care staff are following the same safe sleep policy. – Because having a safe sleep policy is an opportunity to educate parents about safe sleep practices—it opens the door to a discussion between the parents and child care provider about safe sleep. – By making sure that child care providers are taking part in professional development and that they are up-to-date on the best sleep practices. (Continued on next slide) 28a

12 Posición Alterna para Dormir
Requiere del permiso firmado de los padres y proveedor médico Identifica las razones médicas por las cuales el bebé debe de dormir en otra posición que no es de espaldas Informar a todos los maestros y flotantes Mantener una copia en el expediente de la familia y poner una copia en el salón de clases Early on, child care providers should talk with parents about which sleep position is preferable for the baby. Anyone who is a parent and chooses to leave his or her baby in the care of another person should have a conversation with the caregiver about the baby’s sleep position. When reviewing the baby’s application, child care directors or owner/operators should ask, “What position does the baby sleep in at home?” For babies that sleep on their tummies at home, they should ask, “Why?” If there is a valid health reason why a baby should not sleep on the back, the parents should inform the child care provider and discuss it with their child health professional. Requirements around sleep position should become part of the baby’s care plan. If the baby must sleep on his or her side or stomach, you should know the reason why from the child’s health professional. The reasons for a baby to not sleep on its back are extremely rare and should be discussed with the infant’s pediatrician. Written note signed by the baby’s pediatrician Parents should obtain a written statement from the baby’s pediatrician that states the medical reason why the baby is exempt from sleeping on his or her back. (Continued on next slide) 31a

13 Directiva OCDC del Uso de la Cobija (en efecto Mayo 2006)
Para mantener salvos a nuestros niños!!!! ….y seguir las Normas de Ejecución Head Performance

14 Salones de Infantes y los autobuses SOLAMENTE
La cobija de la fotografía es el ÚNICO tipo de cobija que se debe usar en los salones de infantes y en el autobús. Las cobijas de infantes son más pequeñas y ligeras. Estas vienen en dos colores, amarillas y verdes.

15 Blanket Use With Infants: Option 1
Coloque al bebé con sus pies al pie de la cuna. La cobija no debe llegar más arriba del pecho del bebé y las orillas deben estar metidas debajo del colchón de la cuna.

16 Swaddle method: Option 2
Doble una esquina de la cobija. Coloque al bebé sobre la cobija asegurando que la parte superior de la cobija quede a la altura de su pecho. Tome el lado izquierdo de la cobija y pásela de manera ajustada por el pecho del bebé y asegurando la punta por detrás de su cuerpo. Suba la punta inferior de la cobija y ya sea que la doble o la meta dentro del primer doblez. Tome la última punta de la cobija y pásela por el pecho del niño. Asegure la punta por atrás asegurando que los brazos queden libres. Este método de envoltura se puede usar solamente si la cobija está a la altura del pecho dejando los brazos libres fuera de la cobija.

17 Preschool blankets La foto de la cobija azul es la que debe usarse para los niños pequeños (toddlers) y los preescolares. Todas las demás cobijas deben ser removidas del centro y los autobuses. El personal del condado debe informar a los padres las razones detrás de la directiva y el uso de las cobijas en los centros OCDC y en qué forma esto promueve la salud y seguridad de todos los niños.

18 Limpieza La ropa de cama debe lavarse cada vez que se ensucie en el autobús y cada vez que haya cambio de ocupante en los centros. Si se tiene un mismo usuario por cobija, éstas se deben lavar cuando menos una vez a la semana. CCD (I) Las cunas, colchonetas y catres deben espaciarse a cuando menos 3 pies de distancia. HS PS (e)(7)