1135. Infant Safety Education and Intervention

Original Date: October 31, 2014

Revised Date: October 31, 2019

Sunset Review Date: October 31, 2023

Approved by: Jody Becker, Deputy Secretary of Children and Families


Purpose

The purpose of this policy is to provide guidance to Department of Children, Youth, and Families (DCYF) employees working with parents, families, and caregivers who have newborn and infant children to reduce the risk of child abuse and neglect. DCYF is committed to improving infant safety outcomes through early intervention, education and prevention services to parents, families, and caregivers. Children under age one are vulnerable to risk of harm from prenatal substance exposure, accidental suffocation and serious injury from blunt force trauma. This policy does not apply to children who are placed out-of-state through Interstate Compact and Placement of Children.

Scope

This policy applies to DCYF caseworkers and Licensing Division (LD) workers.

Laws

PL 111-320 Child Abuse Prevention Treatment Act (CAPTA) of 2010

PL 114-198 Comprehensive Addiction and Recovery Act (CARA) of 2016

Policy

  1. Newborn: Plan of Safe Care
    Caseworkers must complete a Plan of Safe Care DCYF 15-491 with families as required by the Child Abuse Prevention and Treatment Act (CAPTA) when newborns are:
    1. Identified as substance affected by a medical practitioner. Substances are defined as alcohol, marijuana and any drug with abuse potential, including prescription medications.
    2. Identified as having withdrawal symptoms resulting from prenatal drug and alcohol exposure.
    3. Born to a dependent youth.
  2. Birth to six months: Period of PURPLE Crying
    1. Caseworkers must discuss with parents and caregivers about their knowledge and understanding of “Period of PURPLE Crying” when working with families.
    2. LD workers must ask if parents or caregivers have previously received information on “Period of PURPLE Crying,” when licensing or approving home studies for families accepting placements.
    3. Caseworkers and LD workers must provide educational materials to any parents or caregivers who have not received the information.
  3. Birth to One Year: Infant Safe Sleep
    1. Caseworkers must:
      1. Conduct a safe sleep assessment where the child primarily resides for one of the following, when:
        1. Placing an infant in a new placement setting.
        2. Completing a CPS intervention involving a child aged birth to one year, even if the child is not identified as an alleged victim or an identified child.
      2. Assess safe sleep conditions during subsequent monthly Health and Safety Visits.
    2. LD workers:
      1. Will review the safe sleep environment for infants in licensed and unlicensed placements.
      2. Must assess the sleeping environment and educate the family on safe sleep practices when licensing or approving a home study with families accepting placements for infants.

Procedures

  1. Newborn: Plan of Safe Care
    Caseworkers and LD workers must:
    1. Assess the infants, parents, and caregivers for needs and services.
    2. Document services and supports needed, including contact information, in the Plan of Safe Care DCYF 15-491.
    3. Once the plan is completed:
      1. Complete referrals to any services or resources identified.
      2. Provide a copy to the parents and caregivers.
      3. Upload the original or photo of the completed Plan of Safe Care DCYF 15-491 into FamLink.
  2. Birth to six months: Period of PURPLE Crying
    Caseworkers and LD workers must:
    1. Determine if the parents or caregivers received the “Period of PURPLE Crying” educational DVD or web application.
      1. If received, discuss any questions the parents or caregivers may have regarding the “Period of PURPLE Crying”.
      2. If not received:
        1. Provide the “Period of PURPLE Crying” educational DVD or web application, and the supplemental booklet.
        2. Review and discuss the information outlined in the booklet. The following key points should be relayed to caregivers:
          1. Explain to the parents and caregivers that the acronym “PURPLE” is used to describe specific characteristics of an infant’s crying and that what they are experiencing is normal and a phase in their child’s development.
          2. Explain that parents and caregiver’s frustration due to “Period of Purple Crying” may cause them to shake the baby, which can result in significant, if not life threatening effects.
          3. Reinforce to families, if an infant is crying and they become frustrated they should put the infant down in a safe environment.
        3. Play the 10 minute “PURPLE” video for the parents and caregivers after presenting the booklet, if resources are available, and:
          1. Emphasize the importance of the material presented.
          2. Reinforce to the parents or caregivers that everyone caring for their infant should review the information.
          3. Remind parents and caregivers about the 17-minute soothing film on the DVD or web application is available to help them understand ways to soothe their baby and cope with inconsolable crying periods.
    2. Document in a FamLink case or provider note the following:
      1. When the parents and caregivers received the “Period of PUPRLE Crying” educational DVD or web application and supplemental booklet.
      2. If the parents or caregivers refused to discuss the “Period of PURPLE Crying” materials.
  3. Birth to One Year: Infant Safe Sleep
    Caseworkers and LD workers must:
    1. Complete a safe sleep assessment by assessing the child’s sleeping environment, using the Infant Safe Sleep Guidelines, with parents or caregivers of infants younger than 12 months, during the first face-to-face meeting.
    2. Require the parents or caregivers to create a safe sleep environment. If one does not exist:
      1. Caseworkers can either:
        1. Offer a voucher for the parents or caregivers to purchase a safe sleep option with a firm flat mattress and fitted sheet that meets the national and Consumer Product and Safety Commission standards. Recommendations include the following options:
          1. Cribs
          2. Portable cribs
          3. Bassinets (infant up to 10 lbs.)
        2. Provide parents and caregivers with a firm flat mattress and fitted sheet that meets the national and Consumer Product and Safety Commission standards.
      2. LD workers must not approve a home study without a safe sleep environment.
    3. Consult with the supervisor when there are additional risk factors, e.g., substance use or abuse, mental health issues, etc., associated with the parents or caregiver’s ability to maintain child safety and a safe sleep environment.
    4. Document in FamLink:
      1. Results of the safe sleep assessment, if applicable, for:
        1. Caseworkers in one of the following:
          1. Case notes
          2. Investigative Assessment
          3. FAR Family Assessment
          4. Comprehensive Family Evaluation
        2. For LD workers in one of the following:
          1. Home study
          2. Provider notes
      2. If the caregiver refused to participate in the process of creating a safe sleep environment for the child.
      3. Any safety concerns or risk factors identified in licensed facilities. These concerns must be immediately shared with the licensor.

Forms

Plan of Safe Care DCYF 15-491

Resources

Infant Safe Sleep Guidelines

National Center on Shaken Baby Syndrome

Safe Infant Sleep and Breastfeeding

Safe Sleep for Your Baby

Sudden Infant Death Syndrome (SIDS) and Safe Infant Sleep

The Period of Purple Crying