Manitoba should provide safe place to sleep for infants from poorer families, advocate says

Manitoba's advocate for children and youth wants the province to ensure every infant can sleep on a safe surface to try to eradicate unexpected deaths of children in their sleep.

Daphne Penrose says one in four of those deaths occurred when a child didn't have a safe place to sleep, such as a crib, according to their investigation of 145 unexpected sleep-related deaths over a 10-year period.

Penrose, who released a new report on the subject Friday, found Indigenous infants — who make up 57 per cent of all sleep-related infant deaths but just 30 per cent of the province's live births — were over-represented in their analysis.

The Manitoba advocate for children and youth is asking the province to work with First Nations and Métis governments to ensure any expectant parents and caregivers who cannot afford an appropriate sleeping surface for infants under 24 months have one.

She recommends a specific plan as well for First Nations communities.

"Infant safety is an issue about which all Manitobans ought to be concerned. That we have lost 145 infants over 10 years in our province is a travesty. That most of those deaths may have been preventable is heartbreaking, and ought to be viewed as unacceptable by all of us," Penrose wrote in her report.

Half of the infants died while sleeping on an adult mattress, the study says.

Her office chose to review sleep-related infant deaths after noticing an unexpected spike in 2018 of deaths associated with unsafe sleeping environments, and a lack of recent scholarship on the issue.

The advocate reviewed more than 1,000 infant deaths in the last 10 years, in which 145 of those were deaths where unsafe sleep environments factored into the equation. 

In each case where such information was available, one or more of these risk factors were present at the time of death: bed-sharing, placing the infant to sleep on an unsafe surface or in an unsafe position, objects in the sleeping environment, exposure to tobacco smoke and infant overheating.

In particular, 77 per cent of cases involved infants sleeping on an unsafe surface, 48 per cent showed signs of overheating and half the infants were exposed to tobacco smoke.

Penrose said these parents are putting their kids to bed with the best intentions.

"These are things that parents are doing out of love and kindness, and based on everything they've learned," she told a news conference only accessible through a Facebook live stream due to COVID-19 concerns.

The advocate also found the number of deaths was overrepresented in poorer neighbourhoods. Fifty-eight per cent of all sleep-related infants deaths occurred where the average household income was below $35,000, while a further 30 per cent of deaths occurred in areas where average incomes were between $35,000 and $50,000 a year.

"Clearly more needs to be done to address the structural inequality faced by families and communities, and which pose a risk to the health and well-being of infants," the report says. 

Penrose also recommends the province to develop a public awareness campaign about the issue. There hasn't been a campaign in the decade, the report says.

Her office also wants the province to create a dedicated smoking cessation program for expectant mothers, since smoke is another of the risk factors.

Child and Family Services workers should be required to evaluate an infant's sleeping environment during face-to-face visits in the home, she said. 

CFS should check sleep environment

Among the deaths where CFS was involved with the family, only 46 per cent had a safety assessment in the infant's home environment, the report says. 

The current safety assessments do not consider whether a safe sleeping surface is available, the advocate's office said.

"When CFS is involved in a family, important opportunities are present to provide safe sleep information to expectant parents and to parents of newborn babies. The review of deaths uncovered a number of missed opportunities to ensure the safety of infants."

While a high percentage of sleep-related infant deaths occurred in families who were either receiving CFS services or had in the prior year, only a small number of these cases involved infants who were in CFS care when they died. 

Families Minister Heather Stefanson said the province will be reviewing the advocate's recommendations in more detail in the coming weeks and months. 

"Our hearts go out to every Manitoban who has suffered this loss. I want to thank the advocate's office for its research and dedication to the issues that affect children and families, and for sharing that work in reports such as this," she said.