From Yomiuri Shimbun, August 15, 1997, Morning Edition
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Renaissance in Medical Service 1567
Disseminating Frontline Information throughout Country
Government Belatedly Initiates Investigations
Self-Reproach of Childcare Professional
Mrs. Noriko Nakamura (38), who operates a non-licensed day nursery in Hiroshima City, was conscience-stricken when an infant under her care lost his life. "Even though I was a childcare professional, I had hardly any knowledge of SIDS (sudden infant death syndrome)," she says.
In July 1995, an infant boy of four months died while taking a nap along with other babies forming a circle in a nursery room. He had been put down to sleep face down a little after 11 that morning. It was not until about 1 p.m. that a caregiver noticed that something was wrong with him. The police grilled the nursery staff with piercing questions, and media reporters who besieged the nursery pursued them mercilessly.
Three weeks later, the result of police autopsy revealed that the cause of death was SIDS. It is a medical disorder of unknown causes, and childcare providers are usually not found liable for its occurrence.
The infant's parents, however, had nowhere to channel their anger but toward the nursery. Mrs. Nakamura was at a loss for an answer when the deceased infant's father, subsequently visiting the site where his son had died, asked her "Why didn't you notice something was wrong for so long? Were you really keeping an eye on our child?"
Mrs. Nakamura has four children of her own, the oldest girl being a fifth grader. When her third child was born, volunteers from the consumer's co-operative took care of her two older children. This experience led to her 1991 decision to turn her home into a family nursery. She was motivated to "make a living that would bring joy and happiness to other people."
The death of the infant made her lose confidence in herself, and she agonized over the question of keeping the nursery open. In the end, however, her initial determination remained unwavered. She decided to continue running the nursery for the sake of mothers and children who needed her.
The first thing she did was to collect information on SIDS. The known SIDS risk factors include the prone sleeping position and the overheating of infants' surroundings. "If I had known more about SIDS." "If we had periodically checked the infant's breathing." "If we had noticed it earlier." These thoughts wrung her heart. She was painfully aware of her responsibility as a childcare professional. "I could not embrace the notion that the death could not be helped because it was caused by SIDS."
She had additional air conditioners installed in order to keep the room temperature at appropriate levels. At the nap time, the caregivers now put the babies to sleep on their backs. Using a timer, they periodically check the babies to make sure that they are breathing. They also touch their bodies lightly and stimulate their senses in order to prevent imminent occurrence of SIDS.
Mrs. Nakamura receives inquiries concerning SIDS from other childcare providers. Through conversations with them, she has discovered that many of them are at a loss as to what to do about SIDS and are under serious uneasiness about it. Even though the data available in other advanced nations in the West clearly identify some risk factors, the Japanese government has thus far related little information to the frontline childcare practitioners in the country.
In February of last year, Mrs. Nakamura completed a round of discussions with the family of the deceased infant. The words of the child's mother, who said "Please don't let my baby die in vain; please don't forget my baby's death." were written indelibly on her heart.
Webpage on SIDS Prevention
How can she respond to these wishes of the child's mother? Her answwer was to launch on a SIDS prevention campaign.
In order to effectively communicate the information on SIDS prevention to childcare providers across the country, she made bold to describe in detail the circumstances which led to the death of the infant, and spelled out what she believed to be her "responsibility" in this matter. She developed a list of measures that would help minimize SIDS risks, including "Do not put babies to sleep face down." She also prepared lists of literature on SIDS as well as information on emergency medical treatment and liability insurance. Furthermore, all this information is now made available on a WWW homepage on the Internet.
Mrs. Nakamura has thur far received more than 400 inquiries from across the country, which has made her keenly aware how badly the information is sought by frontline childcare providers. She wonders why the government does not relate information on SIDS to childcare providers and homemakers.
This year, the Ministry of Health and Welfare belatedly begins a fact-finding survey on the relationships between SIDS and the prone sleeping position.
Photo: "I want to relate information on SIDS to as many people as possible," says Mrs. Nakamura, second from left in the back row.
SIDS Prevention Homepage is found at http://www.alles.or.jp/~mammy/ .
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