The policy team at Shelter recently met with the Lullaby Trust after the tragic death of two babies whose families had become homeless. The organisation provides expert advice on safer baby sleep, raises awareness of the causes of sudden infant death and works with bereaved families to provide support. This week The Lullaby Trust is promoting Safer Sleep Week and we asked chief executive Francine Bates to blog for us about the links between sudden infant death and poor housing.
This week, I watched Cathy Come Home, a film that still has the power to shock after 50 years. Cathy has three children; Sean, Stevie and Marlene, an infant baby girl. It was made at a time when Sudden Infant Death Syndrome (SIDS), or Cot Death as it was known, was rife, resulting in thousands of babies dying every year. Towards the end of the film, an increasingly desperate Cathy and other homeless mothers living in a squalid hostel gather round a mother whose baby has died. Cathy angrily confronts the nurse in charge who callously blames the bereaved mother for the death of the baby.
SIDS, although much reduced since the 1960s, sadly still claims the lives of 290 babies and toddlers each year in the UK. Homelessness and poor housing are still significant factors. Two particularly tragic cases occurred last year. In one, a family were evicted from social housing and moved to the home of another family member. The youngest member of the family was a new-born premature baby. He died sleeping on a sofa with his father. In the other, a baby died whilst sleeping in a car with his parents, who were homeless. Both are situations no family with a small baby should find themselves in.
Increasingly, we are hearing stories from around the country of homeless families with young babies being placed in unsuitable accommodation, often in a small room and sometimes with no cot provided.
The causes of SIDS are still unknown but we now know a great deal about the circumstances in which babies die. There are many factors which increase the risk of SIDS. Babies are more likely to die if their mothers are under the age of 20; if they smoke; if an adult who has smoked or drunk alcohol shares a bed, sofa or armchair with the baby; and crucially if a baby is placed face-down to sleep rather than on its back. The evidence is clear: the safest place for a baby to sleep is in their own cot or Moses basket in the parents’ bedroom. Yet, fifty years after Cathy Come Home, thousands of families across the country still don’t have a bedroom or a safe place for their baby to sleep.
SIDS often occurs at times when a baby’s sleep routine is disrupted. If the normal routine becomes chaotic, or a baby has no place of its own to sleep, the risk of SIDS goes up. In times of crisis, some families may not immediately think about the safest place for their baby to sleep. In Cathy Come Home, Cathy moves to a caravan and puts baby Marlene in a washing up bowl to sleep because there is no cot. Although not ideal, this was safer for Marlene than sharing a cramped bed with her parents.
Housing workers have a key role to play when advising and placing homeless families with babies. We’d recommend that they always ask where the baby will be sleeping and make sure that a cot or a Moses basket is provided. As Cathy understood when she put Marlene in a plastic bowl, babies are safer in a separate sleep space. The Lullaby Trust is determined to reduce the number of sudden infant deaths to below 150 by 2020. Our national Safer Sleep Week is taking place this week and we will be launching a short animated film on social media particularly aimed at young parents. Please share the film as widely as possible and help us keep babies safe wherever they sleep.
Safer Sleep week gives us an opportunity to think about how accidents can happen.
Research over the past 50 years has provided us with knowledge to help reduce the risk of babies dying in situations which are potentially preventable. We do not always find out why a baby has died suddenly and unexpectedly and these deaths remain unexplained (SIDS). What we know now is, that if we place babies to sleep safely, they are less likely to die as a result of SIDS.
It is remarkable that Cathy had the insight to place her baby to sleep in a separate environment where she was less likely to become overheated or have any difficulty breathing. When families find themselves in sleeping in circumstances that are less than ideal, infants become increasingly vulnerable. Parents can be struggling to manage several stressors, housing, finances, relationships, food and warmth are some examples. If they have had the information about safe sleeping they can strive to ensure that every sleep is in a safe place, whatever time of day. It becomes essential for all professionals and staff who come into contact with families, to translate the knowledge of how to reduce risks for babies. This is particularly important for providers of temporary accommodation, in housing, hostels or hotels. Parents and babies who sofa surf are also living under a great deal of stress, when they have no place to call their home. In Manchester since 2005 we have had a “Safer sleeping practice for infants” Policy and deliver safe sleep for infants training to all public sector workers who come into contact with parents of babies including midwives, health visitors, sure start workers, housing workers, social workers and foster carers. We also raise money for the provision of cots in temporary environments and travel cots for mobile families. Awareness raising in multi-agency partners has contributed to reducing the incidence of SIDS in Manchester and workers will in turn support parents and educate them to reduce the risks for their infants.
The loss of a child is truly devastating for a parent. When this is as a result of SIDS the family carry the grief down generations and the ripples are felt for a very long time. The Lullaby Trust are the leading light in this country on reducing the incidence of these tragedies and a great resource to support both parents and professionals.