Hawaii Needs To Act Now On New Day Care Rules
The state needs to push through on requirements for safe sleeping practices at day cares more quickly.
Government, we all know, isn鈥檛 the most expeditious or efficient beast. But you鈥檇 still think that government agencies could get it together enough to do what the Hawaii Legislature asks them to — especially when it involves something as important as protecting babies.
You鈥檇 be wrong.
As Civil Beat鈥檚 John Hill reported last week, the Legislature passed a law in 2013 directing the Department of Human Services to outline safe sleeping guidelines at day care centers. This was not a controversial law nor is it a big burden for DHS, considering the best sleeping practices to avoid SUID, or Sudden Unexpected Infant Death Syndrome, are . But here we are, three years later, and DHS has still failed to comply.
In the meantime, three infants have died at day care centers in Hawaii. Sudden Unexpected Infant Death, as any parent knows, is a terrifying and heartbreaking phenomenon that affects infants up to a year old. The category includes SIDS (sudden infant death syndrome) as well as infant deaths from unknown causes and accidental suffocation or strangulation in bed.
While the exact causes of SIDS aren鈥檛 entirely understood, we do know that safe sleeping practices — namely, placing an infant on his or her back, on a firm surface, without any loose blankets or stuffed animals around — can greatly reduce the risk of SUID. It is curious and even infuriating, therefore, that DHS is dragging its feet and failing to put its full weight behind these life-saving guidelines.
DHS, for its聽part, has said it’s聽waiting to debut safe sleep rules in mid-2017 as part of a wide-ranging overhaul of child care regulations. Officials聽say their existing regulations already mandate safe sleep habits — such as each child getting a crib, cot, mat or rug to sleep on. But the rules do not currently address infants sleeping on their back, which is arguably one of the most important regulations that needs to come from DHS.
New parents today are reminded at every corner — from the hospital nurses immediately after delivery to the many pediatrician appointments that follow — that placing a baby to sleep on his or her back is safest.
But this was not always the case. The American Academy of Pediatrics started recommending back sleeping in 1992. Up until then, the put their babies to sleep on their stomachs or sides.
Despite the best efforts of pediatricians, public health experts and concerned parents, there are still care providers who aren鈥檛 familiar with the current best practices. Even well-intentioned providers might not think twice about letting a fussy baby sleep on his side or keeping a conked-out infant in a baby bounce chair. That is what happened, parents say, in聽two recent incidents of infant death at Hawaii day care centers. And therein lies the great irresponsibility of DHS.
There鈥檚 no way to know, of course, if lives could have been saved had DHS followed through with the law back in 2013. But when our government agencies choose to ignore the Legislature鈥檚 directives, especially such simple and well-intentioned directives as this, it undermines their competency and brings into question their priorities.
And unfortunately, it鈥檚 not the first time a Hawaii state agency has failed to follow through. The Department of Health, Civil Beat has previously reported, has repeatedly failed to post inspection reports online for the 1,700 adult care homes and long-term care facilities that it oversees, despite legislation calling for them to do so. It鈥檚 high time both agencies — DHS and DOH — get it together and look out for Hawaii鈥檚 most vulnerable residents.
DHS may be working diligently behind the scenes on its grand overhaul of child care regulations, but the fact that it hasn’t聽addressed safe sleep regulations, specifically the need for infants to be placed on their back to sleep, nearly four years after the Legislature saw a need for it to do so is inexcusable.
