Minnesota has some of the leanest training requirements in the nation with respect to preventing SIDS and limiting other infant hazards at licensed family child care.

The state is one of 26 where in-home providers don't need high school degrees, and one of 10 where providers need no more than nine hours of annual training, according to Child Care Aware of America, a research and advocacy group.

While advocates for the in-home child-care industry deny that their facilities are riskier than child-care centers, they do say improved training could reduce the risk of infant deaths.

Providers' knowledge of sudden infant death syndrome gets outdated, for example, because the state requires SIDS training only every five years, said Michelle Gillard, who provides SIDS and child-care training in southeastern Minnesota. Just in the last five years, views have changed on the use of bumper pads and blankets, which present suffocation risks in cribs.

"I don't think attending a class once every five years is enough," Gillard said.

Even the understanding of SIDS itself has evolved. The mysterious deaths of healthy sleeping infants led to a national back-to-sleep safety campaign in 1994 -- and a 50 percent reduction in the SIDS death rate by 2000. Since that time, public health officials have recognized that some deaths are mistakenly classified as SIDS, when other causes such as accidental suffocation are to blame.

Outdated training shows up in disputes over blankets, Gillard said. The American Academy of Pediatrics now discourages all but lightweight blankets in cribs, and many county licensing agencies prohibit blankets altogether. But inspectors still find providers who use heavy blankets or accede to parents' demands to let infants sleep with stuffed animals.

Child Care Aware recommends that states follow the example of Wisconsin, where providers must graduate from high school and obtain college-level credentials. Wisconsin's annual training requirement is 18 hours.

Training mandates are a thorny issue for family child-care providers, though. The Minnesota Licensed Family Child Care Association has lobbied to increase the state's annual training requirement from six hours to 12 hours. Eight hours was a compromise, in part because some of the association's members resisted an increase, said executive director Katy Chase.

Cost is an issue. Licensed family child care is cheaper than center-based care in Minnesota -- $7,350 per year for an infant compared to $12,900, according to Child Care Aware. Increased training could result in higher costs for parents; in Wisconsin, for example, the annual cost of family child care for an infant is $8,550.

Nevertheless, recent child-care deaths underscore the need for training, Chase said. "There's no cost put on a child's life, OK. This is not a place where we skimp."

The state could help, she said, by funding training and mentoring programs and the association's safety-focused accreditation program. Only two dozen of Minnesota's providers are accredited.

The state is reviewing training requirements in light of the recent deaths, said Jerry Kerber, who directs child-care licensing for the Department of Human Services.

Jeremy Olson • 612-673-7744 jeremy.olson@startribune.com