My Responsibility, Regrets, and Reflections as Childcare Professional

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My Responsibility, Regrets, and Reflections as Childcare Professional on the July 1995 Occurrence of SIDS at Mommy Day Nursery

Date Prepared:  May 24, 1997

Nature of Mommy’s Responsibility

Reflections on My SIDS Experience

My Thoughts on Government Services

On Differences of SIDS Environment at Home and at Day Nurseries

Reasons Why I Ventured to Write on My Responsibility as Childcare Professional

An infant died suddenly while being cared for at Mommy Home Childcare Service, and the death was ruled as caused by SIDS (a medical disorder). Although the nursery was not charged with accidental homicide, the police investigations determined that it was negligent in taking appropriate precautionary measurers before SIDS occurred, and in discovering it immediately after it occurred. That being the case, I believe Mommy as a professional childcare provider must bear the responsibility for the outcome.

Having experienced SIDS at my day nursery, I realize with regrets that I myself failed to live up to my responsibility as a childcare professional. Please note that what I describe below relates solely to Mommy.

Nature of Mommy’s Responsibility   Top of Page

1. That we could not return the infant alive to his family, which was our bounden duty.

2. Despite the presence of a caregiver in the room, we failed to periodically observe the condition of the sleeping infant.

3. That we failed to observe the infant closely after he fell asleep face down.

4. That we neglected to exercise proper control over room temperature.

Having experienced SIDS at my own nursery, I realize with regrets that I failed in these points.

Under the circumstance, the fourth point–room temperature–was clearly included among SIDS risk factors.

I would be very happy if operators of other childcare facilities would reflect on these points in their efforts to minimize the risk of SIDS.

I myself work as one of the caregivers in the nursery. As childcare professionals, we customarily apply our professional knowledge to the task of nursing the infants entrusted to our care.

Our professional environment is such that we are in a position to obtain several times the amount of health-related information–such as ways of preventing diseases–as compared to parents in ordinary home environment. As for SIDS, it was thought in the past that its causes were unknown and therefore there were no ways of preventing it. It is no longer the case now.

Strenuous efforts by medical researchers have resulted in a list of measures which are known to reduce the risk of SIDS. Thus, eliminating these risk factors one by one is crucial in preventing SIDS deaths.

In July 1995, SIDS claimed the precious life of a four-month-old infant at Mommy. At that time, I knew little about SIDS. But ignorance is no excuse. The fact remains that Mommy could not discharge its bounden duty of returning the infant fit and alive to his parents. I feel tremendously guilty about this failure.

This is what I who experienced SIDS at my own nursery feel with deep sorrow and remorse ever since the death of the infant. When SIDS occurred suddenly, I was at a loss as to what to do, and deeply agonized over the incident. For my own pride and sanity, I determined to help the family lessen its grief and suffering by considering their feelings above anything else in what I do. I strongly felt that it was crucial for me to deal with the family as honestly and sincerely as I could.

I then made earnest efforts to deal appropriately with the family, bolstered by the support given me by my customers, children at the nursery, volunteers for the SIDS Family Association Japan, and my husband.

The series of discussions I had with the family of the deceased infant was concluded in February 1996. Since last fall, I have been doing what little I can to help prevent SIDS deaths, keeping firmly in mind the words of the infant’s mother, who told me “Please don’t let my baby die in vain; please don’t forget my baby’s death.”

I am also determined to make good use of my bitter experience as a means to improve my SIDS prevention activities, my nursery work, and my own mode of living.

Through the reports I give to all the customers of Mommy, all my patrons are aware that an infant of four months lost his precious life at Mommy two years ago. Many of them mourn the death of the baby, grieve for the family, shed tears, and offer prayers to the stone image of Jizo, the guardian deity of children, for the soul of the infant. Their children pat the stone image on the head, and offer their prayers putting their small hands flat together. Every time I witness their praying, I myself offer a silent prayer. I am truly grateful to the warm heart of my patrons.

Reflections on My SIDS Experience   Top of Page

It came as a great shock to me to discover that SIDS could occur so quietly. It was inexcusable, however, for a professional day-care provider not to notice for a long time that the infant had stopped breathing. Even today I deeply regret that we could not discover the stoppage of breathing immediately after it occurred.

The room temperature was on the high side because the capacity of the existing air conditioner was not adequate. We had put off increasing the capacity because of the expenses involved.

Even though reading newspaper articles about SIDS made me uneasy, I did not go as far as finding more about it by contacting the SIDS research team at the Ministry of Health and Welfare or the SIDS Family Association Japan.

Reading newspaper articles, I was also concerned about the prone sleeping position. Nonetheless, I did not thoroughly instruct my nursery staff to pay heed to it. The root of the problem, therefore, was my lack of knowledge about SIDS and my optimistic thinking that surely SIDS would not occur at my nursery.

For all these things, ultimate responsibility lies with me who, as a childcare professional and as head of the nursery, failed to gather appropriate information on SIDS and give appropriate instructions to the staff on the ways of lowering the risk of SIDS.

Even though I was trusted by the parents of the deceased infant as a professional day-care provider and was entrusted with his care, I failed to safeguard his precious life. I am simply mortified by the outcome, and feel deeply sorry to the infant and his family.

I am determined to do what I can to help promote SIDS prevention activities and help safeguard as many lives as possible so that the precious little life was not lost in vain.

My Thoughts on Government Services   Top of Page

Thanks to the hard work over the last 13 years by Professor Hiroshi Nishida and other members of the SIDS research team at the Ministry of Health and Welfare, we now know a number of measures we can take to lower the risk of SIDS.

Despite the advance in research and the accumulation of knowledge on SIDS, I wonder why the office in the ministry responsible for childcare matters does not disseminate information on SIDS prevention to day-care facilities across the country. Why can’t the information be relayed to homes by way of maternity passbooks and maternity classes?

I hope the information on SIDS, which is a leading cause of infant mortality, be passed on to the public as soon as possible. There are many who are grief-stricken or unnecessarily worried because of the ignorance of the nature of the fatal disorder.

On Differences of SIDS Environment at Home and at Day Nurseries  Top of Page

In today’s home environment, mothers nurse their babies while doing housework or attend to household affairs while nursing them. In most families, mothers must do it alone, and it is impossible for mothers to devote all their time to nursing their babies. The environment is different at day nurseries where infants are cared for by a professional nursing staff.

We also have a well-developed environment in which the staff can devote fully to the task of nursing. We are responsible to the families for providing a relaxed and wholesome environment for nursing their children.

All the nursery facilities–whether licensed or non-licensed–are inspected each year by the Ministry of Health and Welfare. They presumably meet the criteria established by the ministry for maintaining the acceptable quality of nursing environment and physical facilities.

Furthermore, nursery caregivers are required to keep a close eye on children while they are asleep. In nursing the children placed under their care, nursing practitioners should not base their judgment on preconceived notions. It is critical that they carefully study actual conditions lest they should commit serious errors in judgment.

I therefore ask you to please understand that SIDS at home and SIDS at day-care facilities occur under considerably different circumstances. (This is the conclusion I drew from my experience and regrets.)

Reasons Why I Ventured to Write on My Responsibility as Childcare Professional  Top of Page

* I did so because of my remorse about not being able to safeguard the precious life of the infant for his family.

* As a childcare professional, I bitterly regret that I did not discover that the infant was not breathing until it was too late.

* I do not want to cause other precious little lives to be lost in vain, bringing grief to their families and people around them. Neither do I want to see the nursing professionals to go through the agony I tasted. I sincerely hope that my colleagues in the profession will build on my experience in safeguarding the lives of children entrusted to their care and performing their nursing functions without regrets. To that end, I believe it is vitally important for me to communicate what I consider my responsibility as a childcare professional to my colleagues in the profession, so that they can more effectively lower the risk of SIDS at their own establishments.

* When the cause of the infant’s death was identified, the insurance people told me that the nursery was not liable because SIDS was a disease. Frankly, I myself was tempted by the idea that believing in the statement would somewhat ease the pain in my heart. This doubt suggests how much I was tormented by the death of the infant.

As a nursing practitioner, however, I have many regrets about the infant’s death. “I failed to do the simplest thing–to return the infant fit and alive to his parents.” “I did not notice for a long time that his breathing had stopped.” “If I had only known more about SIDS….” “If we had not put him down to sleep face down….” “If we had checked his breathing periodically….” “If we had been more thorough in monitoring the room temperature….” These thoughts depress me to no end.

Writing on my own responsibility as a nursing professional is very painful to me, and in doing so my heart aches with the sense of guilt toward the deceased infant and his family. I believe, however, that relating with deep regrets my irreparable mistake and painful experience to my colleagues in the profession will help lower the future risk of SIDS at nurseries everywhere. This is why I sincerely hope that my responsibility, regrets, and reflections be communicated to as many nursing professionals as possible so that they can effectively utilize the knowledge to their work of nursing infants while safeguarding their precious lives.

I wrote this article “My Responsibility, Regrets, and Reflections as Childcare Professional” prompted by the book 130 Little Cries which I discovered as I began participating in SIDS prevention activities.

As a childcare practitioner, I was full of remorse about the death of the infant, being able to offer no excuse whatever to his family. Nonetheless, I was perhaps subconsciously resisting the idea of relating my experience in writing to my colleagues in the profession.

I read the book repeatedly. What particularly struck me was the phrase “answering the deceased infants for the mistakes made” found in the “Studies” section (pp. 91-102 of the book) entitled “Study 4: Responses to Fatalities after They Occurred–How We Should Think about Infants’ Deaths.” It says, in part: “Childcare practitioners should sort out and account for the causes of deaths, problems in their nursing practices, and measures they should take to avoid the recurrence of fatalilties. They should then draw lessons from the findings and apply them to their future nursing practices. We believe that the only way for them to assume responsibility for the lives that can never come back is to give meaning to the short lives and premature deaths of the infants.”

Having read this passage, I became convinced that it was absolutely crucial that I myself should carefully reexamine points (1) through (3), and relate what I conclude to be my responsibility aggressively to other childcare practitioners so that they can draw useful lessons from them in their efforts to lower the risk of SIDS.

The most important single prop of my present SIDS prevention activities are the words of the deceased infant’s mother: “Please don’t waste my child’ death.” Mediating on these words, making a humble apology to the deceased infant and his family, morning the infant’s death, and praying for the repose of his soul, I will continue my work on SIDS prevention to safeguard the lives of as many children as possible. I believe this is the one and only thing I can do.

* The “Studies” were written by Mr. Kenji Azuma, representative of the Association for Studying Childcare Issues So That Keiichi-chan Did Not Die in Vain,” which published 130 Little Cries.

I would like to reiterate that the various points I have raised in this article relate solely to the events that took place in my day nursery. They are accounts of my responsibility, regrets, and reflections as a childcare professional. Other nurseries that have been struck by SIDS may have different reflections and responses. I wish the readers of this article clearly understand this point and keep that firmly in mind when they interpret what I have written.


Click here “Studies of 130 Little Cries”

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