Alarmed by a rise in deaths among children in day care, a Faribault lawmaker has proposed that Minnesota hold child-care providers to a tougher standard of safe sleep practices.

Rep. Patti Fritz, DFL-Faribault, filed a bill Tuesday in the wake of a Star Tribune investigation that highlighted a sharp rise in day-care deaths and violations of safe-sleep guidelines by some child-care providers.

Fritz's bill would require a doctor to sign off before a caregiver could place an infant to sleep in some position other than on its back, which is the nationally recognized best practice to reduce the risk of Sudden Infant Death Syndrome (SIDS).

Fritz said she was troubled by the rise in the number deaths in licensed child-care facilities in the past five years and the breakdown of safety guidelines in cases identified by the newspaper.

"This is alarming -- that many infant deaths," said Fritz, a member of the House Health and Human Services Committee, a nurse and grandmother to 17.

Fritz said she doubts there's time to pass the bill in the waning days of this legislative session but wants to get reform underway so legislation can be passed next year. She said the eventual bill might have additional proposals to improve safety for children in day care.

Her bill already has six co-sponsors.

Fritz has tried in the past to get the doctor's approval inserted into the law, but failed in the face of criticism that parents know what's best for their children.

"I'm now on the warpath," she said. "I honestly think this bill could have saved some of these infants."

The rise in deaths documented by the newspaper's investigation correlates with legislation passed five years ago, when the Legislature eased state requirements, from doctor approval to parental approval, to depart from recommended infant sleep guidelines. That change came over the objection of regulators and safe sleep advocates, who said it sent the wrong message across the licensed in-home child-care system, where most of the deaths have occurred.

Difficult position

Many providers say they would prefer the doctor requirement. Before the change five years ago, providers could cite that rule if parents asked that their infants be placed to sleep on their stomachs.

Without that provision, child-care providers can be in the difficult position of resisting the wishes of their customers. Several interviewed say they will not veer from the standard, but must educate parents about the need for safe sleep practices.

Joan Finley, a licensed provider in Apple Valley, said she is a stickler for safe sleep practices and displays safety policies over each crib in her home. She won't depart from the guidelines, even if a parent asks. Still, she thinks the doctor's requirement would be an improvement.

"I think it's better than a parent (approval)," she said. "When a parent does it, they do it because they want their child to be comfortable and sleep. ... I honestly think not many physicians will sign it."

Kathleen Fernbach, director of the Minnesota Sudden Infant Death Center, said she believes the proposal has the potential to save lives.

"It will reinforce for everyone the importance of safe sleep practices," she said.

Brad Schrade • 612-673-4777