This safer sleeping guidance for children is applicable to the multi-disciplinary workforce who have contact with the parents, carers and relatives of babies. The workforce are in a position to discuss sleeping arrangements for baby, support parents to make informed choices regarding safer sleep and raise awareness of factors associated with Sudden Infant Death Syndrome. This guidance underpins the pan-Lancashire safer sleep for baby campaign. In December 2014, NICE released the updated recommendations for professionals on safer sleep. The pan-Lancashire safer sleeping guidance has been amended to reflect CG37 Postnatal care and will support our frontline professionals to implement Quality Standard (QS37) Quality statement 4: Infant health – safer infant sleeping locally.
Aims and objectives
To provide consistent evidenced based advice to parents, carers and families by equipping the multi-agency workforce with a pan-Lancashire agreed policy and materials to deliver safer sleep messages. To ensure all parts of the workforce delivering services to women in the antenatal period and the postnatal period give the same messages regardless of how they feed their baby. Use the guidance to inform the revision of the 'Give me room to breathe' campaign and the associated resources. The guidance will be referenced in commissioning of services.
Reasons for implementing your project
As a result of risk factors (co-sleeping after consuming alcohol, smoking and high room temperature etc.) regularly being identified from unexpected child deaths, it was decided parents and carers needed to be informed of these issues and an awareness raising Campaign was required.
The Give Me Room to Breathe Campaign (GMRTB) was initiated in 2008/09, this was an extension of a police initiative solely run in East Lancashire. As these messages were relevant to all parents and carers, GMRTB was rolled out across the rest of pan-Lancashire. The GMRTB campaign gained national recognition but in 2011/12 it was identified that there was inconsistencies within local services (e.g. breastfeeding peer support workers and children’s centre staff) around the advice given about sleeping with your baby. On further investigation it was highlighted that all agencies across pan-Lancashire were providing slightly different information, using different materials and the professionals themselves were unclear on what they should be advising families.
Pan-Lancashire multi-agency guidance was required to prevent inconsistent messages being given to parents, carers and parents to be. We launched the new safer sleep for baby campaign in 2012/13. Over the last 3 years we have reviewed it regularly and in the last few months two other Local Safeguarding Children Boards (LSCBs) have started using our materials. This has enabled the pan-Lancashire Child Death Overview Panel (CDOP) to lead on ordering resources at a regional level. This is the first step in trying to improve consistency of messages regionally.
How did you implement the project
A multi-agency workshop took place at the beginning of the 2012 financial year to look at safer sleeping messages at the local level. The workshop was very well attended from all areas of the county (including Blackburn and Blackpool) and from all appropriate disciplines' including the police, breastfeeding peer supporters, SUDC nurses, children's centres, midwifery, safeguarding Nurses and Child Death Overview Panel (CDOP). A number of presentations were given which provided evidence based information and highlighted the need for action. One of the presentations was delivered by a NICE specialist committee member, Professor Helen Ball, who was on the committee responsible for updating the safe sleep recommendations within CG37.
It was agreed that the safer sleep guidance required review and to re-launch the GMRTB campaign to be more family friendly and reflect the latest research. The CDOP set up a sub-group, the SUDC Prevention Group, to lead on this work. Due to this being a highly emotive subject which professionals are extremely passionate about we had to overcome a number of issues which we still have to reinforce. The main issue is, professional conflict in terms of what the agreed message should be. We completed extensive consultation with agencies to ensure stakeholders felt involved and to ensure we took all views on board. After listening to the evidence provided by Prof. Ball the LSCB's agreed the guidance should be developed from "do not bed share with your baby" to recognising that co-sleeping occurs whether intentional or unintentional and that parents and carers should be informed that there is an association between co-sleeping and SIDS. The SUDC Prevention Group has had a budget of approximately £30,000 per annum to deliver the Campaign.
How this money is spent has changed over the years depending on feedback and evaluations e.g. in the first year we funded a radio campaign but the evaluation demonstrated that the message did not reach the majority of the target audience and to those it did reach, the information was not remembered. We now focus on providing frontline professionals with materials and developing new resources and providing professionals with training were possible.
The information and campaign resources were updated and rebranded following consultation and focus groups with parents/ carers. Key points in time were identified to deliver the messages to parents and carers. We also established which professionals should be delivering these messages. The revised campaign was underpinned by the evidence based updated pan-Lancashire guidance. Different resources (thermometer, cot card, post card, booklet etc) with the same messages but varying levels of detail were given to different agencies to support them in providing information to families. This also resulted in a 'drip approach' to providing the same message to families in different ways to hopefully remind and reinforce the information.
An evaluation was commissioned to find out how effective parents and carers with new-born babies thought the campaign was, and what their thoughts on the six steps were. Paper questionnaires were distributed to parents and carers through registrars from the end of July 2013 and through children's centres from November 2013. The fieldwork ended on 14 February 2014.
In total, 421 questionnaires were returned. The key findings were:
- Almost three-fifths of respondents (59%) had seen or heard about the safer sleep for baby campaign before visiting the registrar.
- Over half of respondents (54%) had heard of the safer sleep for baby campaign from a health professional. Half of respondents (50%) had heard of or seen the safer sleep for baby campaign at a children's centre.
- Over three-fifths of respondents (63%) had picked up or been given either a cot hanger thermometer, teddy bear postcard or a safer sleep for baby booklet before visiting the registrar.
- More than nine in every ten respondents (93%) agree that the safer sleep for baby information is useful. Almost three-fifths (58%) strongly agree.
- Around two-fifths of respondents (44%) said that they could recall seeing the safer sleep for baby poster somewhere, and around two-fifths (41%) said they couldn't.
- Over two-thirds of respondents (67%) do not remember hearing adverts on local radio promoting the safer sleep for baby campaign. However, almost a quarter (24%) do remember hearing them.
- Almost all respondents (96%) agree with the statement, 'The Safer Sleep for Baby campaign will help parents provide safer sleep for their baby'.
- Almost three-quarters of respondents (73%) have received advice about how their new-born baby should be sleeping.
Key learning points
• To get all parties around the table at the start of the process.
• To identify the evidence base upon which the process to develop local guidance should reflect.
• Identify all of the current leaflets/ posters etc. so it is all taken into account and on the table for discussion at the start.
• Get a big table and book a series of meeting for consultation.
• Get representation from all key stakeholders involved at each consultation meeting.
• Add in other consultation sessions to include those that can't attend.
• Don't leave any party out as this will give them the OK not to follow the guidance.
• Have a small task and finish group to oversee the work to ensure it moves forward and is effective