Kids are safe with family care providers

Counterpoint

The Star Tribune series by Brad Schrade, Jeremy Olson and Glenn Howatt on SIDS deaths ("The day-care threat," May 6, 20 and 30, and July 15) has described the intense pain and devastation of losing a child. After great success in lowering the incidence of SIDS since the mid-1990s, Minnesota is seeing an upward trend in SIDS in homes and care programs in the last five years.

There is not one simple answer. Reactions by the public and legislators must be well-informed. Well-intentioned responses can have unintended negative consequences.

We met with Schrade and Olson at an accredited family child-care home to demonstrate what safe, high-quality environments look like, and to dispel the tone and direction taken against the family child-care profession. We shared possible solutions and points not included in their articles.

The Minnesota Sudden Infant Death Center reports that over the past five years, there were 419 infant deaths -- 47 in licensed family child care, two in licensed centers, 27 in other nonparental care and 343 in parental care. In the previous five years, there had been 358 infant deaths -- 21 in licensed family child care, one in a licensed center, 22 in other nonparental care and 314 in parental care. These figures reflect an increase in infant deaths in all settings.

While 99 percent of licensed family child-care providers, caring for more than 100,000 children, have not had a serious incident, the tragedy lies in the small percentage who did. Minnesota has safe-sleep regulations and requires safe-sleep training for licensed providers. Before solutions can be effective, there must be further analysis of individual cases to understand all the contributing factors related to the increase, in the child's home and in a care setting.

Essential solutions begin with addressing conflicting messages that arise when doctors advise tummy sleep based on a medical need or when parents choose tummy sleep and attempt to direct the provider to do the same. Mixed messages are delivered via marketing companies showing cribs with soft materials and tummy-sleeping babies. Reigniting a "back to sleep" campaign with a clear message is vital.

Funding for county licensing agencies, which monitor family child-care homes, has been dramatically cut and generally reduces licensing visits to once every two years or upon complaint. Simply adding regulations or mandating lower ratios will have the unintended consequence of putting more children in unregulated and illegal care.

Solutions are found in education initiatives like those offered through the Minnesota Licensed Family Child Care Association. The Parent Aware initiative is excellent, yet it is limited in capacity. The Race to the Top funds sound like a lot of money, but when there are vast numbers of children who need to benefit, it offers only a few hundred dollars per child on a one-time basis.

Solutions that improve access for parents choosing quality child care are important. Minnesota's Child Care Resource and Referral Agencies provide a wealth of support, yet are unknown or underutilized, as is the Department of Human Services daily e-mail report on correction orders made in licensed facilities. To subscribe to this e-mail, visit licensinglookup.dhs.state.mn.us/Subscribe.aspx.

As difficult as the Star Tribune's articles are for grieving families and the vast majority of quality providers, the reporters missed the opportunity to look for solutions that support high-quality care.

It is our hope that future reporting will look at the most current pediatric research to understand the long and complex list of what we could be doing to lower infant deaths and how dollars can be reallocated to implement possible solutions. Our association's mission is to support the highest standard of care for children.