Enriching ECHO (Environmental Influences on Child Health Outcomes) with High-risk Pregnancies and Children with Disabilities

Quality improvement (QI) work is driven by an interest in implementing changes that lead to improvements. In breastfeeding and safe sleep work, this can be challenging. It can be difficult to fully and accurately understand the source of maternal and child health inequities. Learn how National Action Partnership to Promote Safe Sleep Improvement in Innovation Network (NAPPSS-IIN) project confronted these challenges and found that community-based participatory quality improvement might hold the answer. As NAPPSS-IIN concludes its fifth year of breastfeeding and safe sleep work, three key lessons have emerged about the value of community voice in breastfeeding and safe sleep quality improvement. 

Sudden infant death syndrome (SIDS) is the leading cause of death for infants and is highly correlated with unsafe sleep practices, which is why the Collaborative Improvement and Innovation Network to Reduce Infant Mortality (Infant Mortality CoIIN) has made safe sleep practices one of its six focus areas.

Black families are twice as likely as white families to have their baby die in the first year of life. These statistics are more than numbers; they represent real families who suffer unimaginable loss—loss that stems from the persistent effects of systemic racism on the health of black families. Here, faculty experts on a national safe sleep and breastfeeding initiative share their recommendations for how health professionals and improvement initiatives can better support the health and well-being of black families.

When Indigenous people were dispossessed from their land, they not only lost their homes but were separated from their way of life. And in many cases, children were forcefully taken from their families. How do we synthesize the promotion of breastfeeding and safe sleep practices among within the context of this historical trauma? Collectively our Indigenous healthcare professionals offer three ideas. 

A recent American Academy of Pediatrics article concluded that, due to national SUID rates stagnation, states needed to re-examine their efforts to improve safe-sleep practices. We couldn’t agree more that these statistics invite increased focus on sleep-related deaths. However, along with understanding where progress has stalled, there is much to learn from progress that has been made and take steps to leverage those successes. 

Understanding what causes infant deaths gives states and communities the information they need to identify focused, effective solutions. This makes infant mortality data—data that reveals the causes and contributors to death and system barriers—irreplaceable assets for any infant health improvement effort. And that makes the National Center for Fatality Review and Prevention (National CFRP) an essential partner.

It's vitally important that parents and other infant caregivers receive consistent and accurate messaging on safe sleep. But unfortunately, expectant families receive a lot of mixed messages. We all need to do a better job translating what the research identifies as best practices into helping families in the day-to-day practice of caring for their infants.

Safe sleep messages are often contradicted in advertising. This culture of mixed messages not only confuses parents, according to a recent study from the American Academy of Pediatrics, but it also makes clinician’s work on safe sleep practices more challenging.

Consistent, evidence-based advice on safe sleep and breastfeeding, whether in a hospital or at home, could improve maternal and infant health outcomes, save babies’ lives, and address significant racial disparities. Learn how a national initiative is seizing every opportunity to support caregivers and babies by working with hospitals and prenatal care centers, social service agencies, and other community touch points across the country.

Physicians, nurses, home visitors and other public health professionals can use this video quiz as an interactive, visual tool to prompt discussions around best-practices for infant sleep.

The Spanish-language version of our popular video quiz to help physicians, nurses, home visitors and other public health professionals can  prompt discussions around best-practices for infant sleep.

This interactive E-handout helps families learn about safe sleep practices. Health professionals can sit with families and click through the pages where they’ll find different sleep scenes and environments. A series of prompts and pop-ups show what is and is not safe and inspire learning conversations. Families can also access the handout at home and use it to teach their friends and families about safe sleep.

BOSTON – Community-based approaches to infant safe sleep and breastfeeding promotion: a qualitative study, led by the National Institute for Children’s Health Quality (NICHQ), details opportunities and challenges to improve community-level promotion of infant safe sleep (ISS) and breastfeeding in communities vulnerable to infant safe sleep and breastfeeding disparities. Published: March 7, 2023 | BMC Public Health

BOSTON – Maternity Care Clinicians’ Experiences Promoting Infant Safe Sleep and Breastfeeding During the COVID-19 Pandemic details findings from a study led by NICHQ researchers of maternity care services of 10 U.S. hospitals from April through September 2020. Participants were asked about challenges and opportunities promoting infant safe sleep and breastfeeding during the pandemic. Published: March 10, 2023 | Nursing for Women's Health