CDOP Briefing Paper 2: May 2016

This paper captures stories of interest that have arisen since the last meeting and that we feel the panel may wish to discuss or comment on:

National CDOP Network Survey; Sharing CDOP Reports with Parents

Liverpool CDOP sent out a request to the CDOP Network to find out if they had been approached by Parents in the past with requests to see CDOP reports on the death of their child and to ask what action CDOPs been taken. 24 CDOPs responded (including West Sussex) and out of these 14 CDOPs had not received any requests for Form Cs or Form Bs to be shared with parents. Of those that have received requests the most common approaches were to:

  • Arrange for a clinical lead (Paediatrician, Obstetrician ) to meet with the Parents to talk them through the findings of the CDOP and answer any questions they may have
  • Arrange for the Chair of CDOP to phone, write or meet with the family to talk through the lessons learnt from the review of their child’s death

Generally it was felt that the Form B and Form C was not a document that should be sent to Parents as the information contained within is owned by the different agencies and could contain classified information (e.g. relating to police intelligence, drugs and alcohol records, DV etc). Most stated that they would seek legal advice before sharing any information.

It was recognised however that the request from families often stems from distress that is being felt that information is being kept from them and therefore a meeting with a clinical lead or chair of CDOP to discuss the review and the outcomes would be the most helpful and supportive approach.

One CDOP writes to all Parents once a child death notification has been received to ask them if there is any information they would like to share with the CDOP or if they would like to be kept informed of progress and any outcomes from the process. Generally Parents do not take them up on the offer but it opens the door for dialogue and gives parents a chance to ask questions and get answers.

It is hoped that the National Network of CDOPs will offer clearer guidance on this in the future so that practices can be more consistent across the country.

Food Allergies – Travelling Abroad

Travelling abroad with a child that has a food allergy is often tricky if Parents cannot speak the language of the country they visiting. CDOP has been looking into what guidance and helpful materials there may be that could help families when they travel abroad so that they can communicate effectively with local people about their Child’s specific health needs. Allergy UK offer translation cards for parents to use when travelling abroad. Go to click on translation cards. These cards are available for over 70 different allergens and available in 36 languages. It costs £15 for 3 translation cards. Showing the cards, appropriate to the allergy, in restaurants, cafes, hotels etc whilst on holiday could save lives!

Safer Sleeping Questionnaire – Jan 2016

In January 2016 a questionnaire was sent out to 163 Health Visitors in West Sussex to gauge their level of confidence and knowledge in delivering the Safer Sleep message to families. The return rate was 25% (41 questionnaires). The survey showed that Health Visitors have a high level of knowledge and confidence when giving safer sleep advice to families but are less confidence when giving advice about the following:

  • Different sleep equipment
  • Reflux
  • Minor illnesses

Further training in these aspects will therefore be required.

Drowning Prevention Week

Swimming pools, paddling pools and hot tubs whether at home or on holiday are dangerous places for children. Drowning is the third highest cause of accidental deaths of children in the UK, and swimming pools are one of the three most common places for a child to drown. Every year there is a Drowning Prevention Weekthat is held in June.

The Child Accident Prevention Trust site also gives families some good advice on how to keep their children safe around swimming pools.

As part of the Water Safety Week in June the Sussex Community NHS Trust has published an information sheet for families and carers. See Annex A below.

Child Deaths – Baby Bouncers

Cumbria LSCB has recently brought our attention to 2 child deaths in their area related to babies being put in baby bouncers to sleep overnight. They have canvassed other CDOPs to find out if there have been other deaths of this nature recorded by them. Responses showed that 4 other CDOPs had experienced similar deaths and so in total there had been 7 deaths across 5 CDOPs. It has been reported that in all cases the babies had been left to sleep overnight in baby bouncers and all had reported the babies as having “snuffles”.

There has been research in the US which looked into 47 child deathsassociated with sitting or carrying devices. The deaths, all of children aged under two, were all reported to the US Consumer Product Safety Commission and involved sitting and carrying devices between April 2004 and December 2008. All but one was found to have died as a result of asphyxia, or strangulation. Two thirds of the cases related to deaths in car seats and the remaining deaths were recorded to have happened in slings, swings, bouncers and strollers.

The research led to the following recommendations / key points for parents to remember when putting their children to sleep:

  • Do not leave children unsupervised
  • Never leave children in a car seat with unbuckled or partially buckled straps
  • Car seats should never be placed on a soft or unstable surface
  • Infants in bouncers, strollers, and swings may be able to manoeuvre into positions that could compromise their airway; straps on devices may not prevent infants getting into hazardous situations
  • Ensure that infants cannot twist their heads into soft bedding or slump forward in a seat; restraints should be used according to manufacturer's instructions
  • Slings are particularly hazardous because of their design and the ease with which an infant's airway can be collapsed. If used, a baby's face should be visible and 'kissable' at all times
  • Do not place more than one infant together in a swing meant for one infant

See also Annex CBelow which is a Safer Sleep Advice sheet issued by Sussex Community NHS Trust. For further advice on the use of Baby SlingsSee Annex BBelow.

Guidance on the SIDS risks associated with swaddling babies and covering babies with blankets can be found at the following links:

Safeguarding Children during Heatwaves

The Public Health England Heatwave Plan for England and associated documents has now been published. This includes advice for “Looking after children and those in early years settings during heatwaves: Guidance for teachers and professionals” This paperlooks at the risks to children, symptoms to look out for, actions to take to prevent illness and what to do when symptoms arise. The guidance can be found at:

Sussex Community NHS Trusthas issued guidance on how to protect babies and young children during heatwaves which can be found in theSafe Sleeping Advice Sheet –May 2016.

Maggie Pugh

CDOP Co-Ordinator

Annex A

Dear Colleagues,

Young children can be fascinated by water and splashing about is great fun. With summer approaching please raise awareness of the importance of keeping children safe near water by displaying resources and engaging parents and carers about this important safety message.

Did you know?

  • Babies and toddlers drown silently in as little as 5cm of water; even rainwater collecting in a bucket can be a danger for a small child (CAPT)
  • Young children can also drown in swimming pools. In the last six years, 30 children under 10 have drowned in a hotel or villa pool abroad. This usually happens when they wander away from their parents and fall into the pool (CAPT)
  • Most drownings involving two to three year olds happen in the home and garden (CAPT).

Top tips for a safe splashy summer

  • It’s safest to empty a paddling pool after use and securely cover water tanks and drains
  • Consider filling in garden ponds or make sure they are securely covered. Also make sure the garden is secure so that a child can’t get to a neighbour’s pond
  • On beaches check when the tide will be high and low and make sure that you won’t be cut off from the beach exit by the rising tide
  • Inflatable dinghies or lilos are a well-known hazard – it’s easy for them to be blown out to sea
  • Children need to be supervised around water. They might understand instructions but are likely to forget if they are having fun or are excited (CAPT).

Resources

  • Child Accident Prevention Trust. Information and advice including leaflets –
  • Toddlers and up - Top safety tips
  • How safe is your child in the garden? Also available from L09/32
  • Royal Lifesaving Society Drowning Prevention Week Information and advice about beach and pool safety
  • RNLIDownloadable activity posters primarily aimed at 4+ years, but could be used to engage younger children.

Annex B: Using Baby Slings Safely

Annex C: Safer Sleep Advice

Annette Lawance-Owen, Health4Families Programme Lead for SIDS, would like to raise awareness about the following information to highlight safer sleep advice with parents and carers.

Bouncer Chairs

There have been 5 recent sudden deaths of babies who were sleeping in baby bouncer chairs. Although it is not possible to identify that these babies died as a result of being in the bouncy chairs, they were in unsafe sleep environments.

Lullaby Trust advice

  • Always place your baby on their back to sleep
  • Place your baby to sleep in a separate cot or Moses basket in the same room as you for the first 6 months
  • Use a firm, flat, waterproof mattress in good condition

Swaddling

Recent research by Bristol University suggests that the risk of sudden infant death syndrome appears to increase when infants are swaddled while sleeping on their stomachs or sides.

Lullaby Trust

Do not advise for or against swaddling, but urge parents to follow the advice below. If parents do decide to adopt swaddling, it should be done for each day and night time sleep as part of a regular routine:

  • Always place your baby on their back to sleep, never put a swaddled baby to sleep on their front
  • Do not swaddle above the shoulders
  • Do not swaddle too tight
  • Check the baby's temperature to ensure they do not get too hot
  • Use a thin material

Sun shades

Covering a buggy with a towel of blanket to shield a baby from the sun may cause the temperature to rise inside the buggy or pram

Lullaby Trust advice

  • It is important that a baby does not get too hot
  • Babies should be checked to ensure they are at a suitable temperature

Lullaby Trust downloadable guides

  • Safer sleep for babies - A guide for parents
  • Safer sleep for babies - Easy read card