From Komei Shimbun, November 14, 1997

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Towards Prevention of SIDS (Sudden Infant Death Syndrome)
No More Tragedies : A Childcare Professional Mounts Attack on SIDS
Prudence Calls for Checking Breathing Every 10 Minutes

“Surely SIDS will not occur at my nursery.” This false sense of security invites SIDS. Of all the SIDS cases, four-fifths occur at home and the remaining fifth occur in hospitals and childcare facilities.

When SIDS deaths occur at childcare facilities, those in charge of operation often try to shirk their responsibility. Ms. Noriko Nakamura (38) who operates Mommy Home Childcare Service, a non-licensed day nursery in Asaminami-ku, Hiroshima City, is a notable exception. Her bitter experience of losing an infant under her care to SIDS has prompted her to conduct a nationwide SIDS prevention campaign from the standpoint of a childcare professional, with a view toward saving as many precious little lives as possible.

In July 1995, a four-month-old infant died of SIDS at Ms. Nakamura’s nursery. He had taken plenty of milk and played cheerfully before taking a nap. He was placed in bed face down. There were no visible warning signs whatever. At a little past two in the afternoon, a caregiver discovered that he was not breathing. He was immediately given an emergency medical treatment and rushed to a hospital, but it was too late.

She was called a “murderer,” and the mass media suspected her of child abuse. Before visiting the family of the deceased infant for making a call of condolence, she wrote a will asking that her four children be properly taken care of. She felt she had to accept the fate if she were to be killed by the family.

Three weeks later she learned that the cause of death was SIDS. Even though it turned out to be a medical disorder, the fact remained that a precious life had been lost at her nursery. She spent many days tormented by bitter remorse, deep sorrow, and a sense of guilt toward the family of the victim.

Two occasions subsequently prompted her to launch her SIDS prevention campaign. The first was the heartrending appeal by the child’s mother, who said “Please don’t let my baby die in vain; please don’t forget my baby’s death.” The other was an encounter with a booklet, 130 Little Cries, a 1982 publication that reported the results of investigations into accidental deaths at day nurseries. This booklet strengthened Ms. Nakamura’s conviction that her mission was to pass on her experience to other childcare professionals as a lesson to be learned for preventing SIDS deaths.

In December 1972, Keiichi-chan, an infant of one year and two months and the eldest son of Kenji Azuma (now 56), author of the booklet, died at a day nursery in Adachi-ku, Tokyo during his nap with his head covered with bedding. Keiichi-chan’s death prompted the organization of the Association For Studying Childcare Issues So That Keiichi-chan Did Not Die In Vain. The association members spent about ten years closely examining the 130 cases of accidental deaths that had occurred during 1968-82 at childcare facilities across the country, the results of which they published as 130 Little Cries.

The report warned of the danger of prone sleeping much before the SIDS research team of the Ministry of Health and Welfare issued a similar warning, pointing out that 83% of the deaths in the 130 cases with the exceptions of drowning and falling were caused by prone sleeping. It also shed light on the lack of attention paid by caregivers to infants during their nap time and on the high incidence of accidents while babies are left alone with no caregivers nearby. The content of the report is highly relevant even today, 15 years after it was first published.

As the first step of her SIDS prevention campaign, Ms. Nakamura wrote a report on the SIDS death that occurred at her nursery. As national and local newspapers published stories on her report, she began getting a rush of phone calls from other childcare professionals across the country. She was astonished to learn from these calls that “even public daycare centers were not provided with adequate information on SIDS.”

With a sense of urgency, Ms. Nakamura wasted little time in developing a guideline to be used by childcare practitioners for minimizing the risk of SIDS. The 5-point guideline consisted of the following.

* Do not place an infant face down to sleep.
* Place the blanket below the neck of the baby; avoid covering part of the face.
* Do not overheat the infant’s surroundings.
* Use a timer to check the infant’s breathing every 10 minutes; at the same time, check the body by touching it.
* Be able to apply artificial respiration. (Get training in CPR methods.)

While observing these rules at her own nursery, Ms. Nakamura distributed the guideline to all the childcare-related organizations across the country. She also created a World Wide Web site on the Internet, and uploaded both Japanese and English versions of her SIDS home pages. At present, she is making preparations for sending materials on SIDS to about 830 municipalities throughout the country. She is also busy with activities which include answering questions on the telephone, giving speeches, and republishing 130 Little Cries.

Ms. Nakamura’s Web site has been accessed 2,300 times, and she has received more than 400 telephone calls. These numbers show that the public’s interest in her work is rising.

On checking babies’ breathing once every ten minutes, Nakamura says, “We cannot detect an imminent SIDS attack by visual observation alone. Although checking breathing involves a considerable amount of work, it is indispensable for safeguarding the children’s lives, and it gives us a peace of mind.”

Mr. Azuma, delighted with the republication of 130 Little Cries, longs for the day when babies no longer die at childcare facilities, saying “The conditions at day nurseries remain essentially the same as they were 25 years ago. It is indeed heartbreaking.” Ms. Nakamura says, “Fifteen years ago, the danger of prone sleeping was pointed out with the sacrifice of 130 little lives. Why hasn’t the government been able to take appropriate measures? I would like to urge the government to spread information about SIDS to all the childcare facilities across the country.” Citizens who are active in the SIDS prevention campaign do not hide their irritation at the slow pace of the government’s response to the problem, wondering “How much longer will the government proceed with utmost caution when lives are being lost each day?”

To effect a significant reduction in the rates of SIDS deaths, a private preventive campaign aimed at parents must be accompanied by governmental guidance given to childcare facilities and hospitals. The two will work synergistically, bringing about a prompt dissemination of information on minimizing SIDS risks. For this to happen, it is imperative that the Ministry of Health and Welfare undertake the task as a ministry-wide program.

At present, there are 22,452 licensed childcare nurseries across the country for which the state sets minimum standards and dispenses public funds. Additionally, there are 9,387 private non-licensed nurseries. National and local government agencies assume an attitude of indifference toward problems that arise at non-licensed nurseries. In their efforts to disseminate information on SIDS prevention, however, they should not discriminate one class of childcare facilities against the other.

(For directing inquiries to Mommy Home Childcare Service, URL is: .)

Ms. Nakamura checks breathing every ten minutes.

This article is translated into English by Mommy Home Childcare Service and reproduced here with permission of Komei Shimbun. Mommy Home Childcare Service is solely responsible for the accuracy of translation. All acts of copyright infringement including reproduction, translation, transmission, republication, and distribution of this material without written permission of Komei Shimbun, the copyright holder, are prohibited.

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