Today, the Pennsylvania Department of Human Services (DHS) released a new series of resources to help communities and child welfare professionals protect infants and ultimately reduce the number of preventable infant deaths across the Commonwealth.

Thanks to a fiscal year 2023 grant from DHS, these resources were developed by the University of Pittsburgh to create educational resources for case workers and caregivers on safe sleeping conditions.

“Even one infant death is too many, especially when that death could have been prevented with better education around how to keep children safe when they are sleeping,” said DHS Secretary Dr. Val Arkoosh. “We hope this toolkit and additional educational resources made possible by the DHS grant provide the information and protocols that child services professionals, caregivers, and others need to help us protect infants and further reduce preventable deaths in Pennsylvania.”

One of the resources available is a new toolkit that will support child death review (CDR) teams across the Commonwealth by providing protocols and resources specifically for reviewing cases of Sudden Unexpected Infant Death (SUID). CDR began in Pennsylvania roughly 30 years ago as a grassroots effort in several counties with the goal of preventing the deaths of children. Act 87 of 2008 codified the program. The CDR model in Pennsylvania is county-based, and multidisciplinary local teams meet to review the circumstances surrounding the deaths of all children aged 21 years and younger.

Most SUID cases occur in infants who are sleeping in an unsafe sleep environment. Many of the risks for SUIDs are also risks for Child Protective Services (CPS) involvement including substance use and maternal depression. In October 2022, DHS awarded a three-year grant to the University of Pittsburgh to support programing to reduce SUID among families with CPS involvement with a focus on substance-exposed infants.

Although this toolkit was developed for the review of SUID cases by CDR teams, its overall approach and many of the included resources can also be applied to the review of any child death, including those examined by child welfare agencies.

“Preventable infant deaths remain a significant public health concern in many communities across the United States,” said Michelle Clayton, MD, associate professor of pediatrics at the University of Pittsburgh, and chief, Division of Child Advocacy at UPMC Children’s Hospital of Pittsburgh. “While medical advancements have dramatically reduced infant mortality rates over the years, numerous deaths could still be avoided through education, awareness, and access to resources. The launch of this dedicated toolkit will help our local and regional communities address this issue and is a vital step toward safeguarding the health of our children.”

In addition to the toolkit, other resources made possible by this grant include:

• A one-hour safe sleep webinar. The webinar has been presented in-person and virtually to nearly 1,000 CPS case workers in Pennsylvania with at least one caseworker from 60 of Pennsylvania’s 67 counties attending.
• A landing page on the Cribs for Kids website specifically for child welfare case workers. Cribs for Kids is a national safe sleep organization located in Pennsylvania.
• A Safe Sleep Assessment Tool and FAQ on common safe sleep related questions for caseworkers to use when talking with families.
• An animated video series with topics specific to reducing SUID in substance-exposed infants will be available later in 2025.

The Pennsylvania Department of Health publishes an annual child death review report to summarize the findings from CDR teams and make recommendations about how to use those findings to inform prevention strategies and programming.

The 2024 report reviewed 75 SUID cases that took place in 2022, and documented the following statistics:

• Unsafe sleep factors were present in 91% of cases. These factors included unsafe sleep surfaces (adult beds, couches, car seats, etc.) and/or items in the sleep area such as blankets, pillows, toys, or other humans and/or animals.
• A safe sleep space was available for the infant in 62% of cases.

Sleep Safe education is just one program included in the Keep Kids Safe initiative through Pennsylvania Department of Human Services Office of Children, Youth, and Families. For more information and resources, visit the Keep Kids Safe page on DHS’ website.