Project Moses
By <A HREF="http://southflorida.sun-sentinel.com/careers/vitalsigns/partfolder/#author">Carol M. Tighe RNC, CCE</A>
Project Moses distributes portable bassinets to parents upon discharge for
all newborns who do not have a safe place to sleep.
I have been a maternal-child nurse working for Naples Community Hospital’s
Community Home Services in Collier County, Fla. since 1997. In February 1999,
one of our nurses did a home visit on a 2-day-old newborn who was found to be
healthy. The next day, our office received a call that the baby was dead on
arrival to our hospital. We were all shocked and very saddened. Weeks later, we
found out that the baby died from suffocation in the parents’ bed from
over-lying.
This incident was so disturbing to me that I decided to research this
"over-lying/bed sharing suffocation death" tragedy. I contacted The U.S. Consumer
Product Safety Commission (CPSC) and requested information. I received a call
back from Suad Nakamura, PhD, who co-wrote an article on this hazard for the
Archives of Pediatrics and Adolescent Medicine in October, 1999, and who is the
directorate for epidemiology and health science at the Commission in Bethesda,
Md. She wrote in her article that "Placing children younger than 2 years old to
sleep in adult beds exposes them to potentially fatal hazards that are
generally not recognized by the parent or caregiver. These hazards include overlying
by a parent, sibling or other adult sharing the bed; entrapment or wedging of
the child between the mattress and another object; head entrapment in bed
railings; and suffocation on water beds. Parents and caregivers should be alerted
to these avoidable hazards." I was further shocked to learn that suffocation
in adult beds "may contribute to as many as 900 infants’ deaths each year"
(Nakamura, Wind & Danello, 1999). In this same study, it was found that in a
7-year period that involved 515 infant deaths, 264 were infants under 1 year of
age. Of these 515 deaths, 121 were reported to be due to overlying of the child
by another individual and 394 were due to entrapment. Of these 121 overlying
deaths, most of the infants were less than 3 months old. The researchers were
careful to exclude any babies whose deaths were due to sudden infant death
syndrome or SIDS.
In April 2000, in Madison, Conn., it was reported that a 4-month-old was
smothered to death when his mother rolled over on him while sleeping in her bed.
Blood vessels that take blood to and from the brain and carotid sinuses are
located in the soft tissues of the neck. They are vulnerable to compression. As
little as 2 kg. (4.4 lb.) of pressure on the neck can result in vascular
occlusion.1 Inadequate oxygen transport to tissues due to obstruction of blood
circulation leads to brain hypoxia and can also result in cardiac arrest when the
carotid sinus-vagal reflex is stimulated.2
The risk of death for an infant in an adult bed is 20 times greater than that
of an infant sleeping alone in a crib, according to researchers from the CPSC
and the National Institute of Child Health and Development. (Sheers &
Rutherford, 2001). In my opinion, one preventable death should be enough for any
parent to avoid this practice.
After my research, I was determined to do something about this and at the
very least, do it in my community. It was with this in mind that I awakened at 3
a.m. one morning with a solution. Moses, as the Bible tells us, was in a
basket –why not a basket for a baby? The very next day, I was in the stores
measuring baskets. I found Rubbermaid made a clear plastic storage container with
similar dimensions to the hospital nursery bassinets.
That March, I took my container to my pastor, the Rev. Joseph E. Stearns at
St. William’s Catholic Church in Naples, to see if he could help me find women
to sew covers for these containers. I told him I wanted to call this endeavor
"Project Moses." He instantly gave me his support and directed me to the
president of the Catholic Council of Women, Marilyn Bogen. I spoke to her and she
got goose bumps – and said that someone had donated rolls and rolls of baby
material a few months ago, which was in the back of the church. Thus began the
birth of Project Moses in March of 1999.
The project is headed by Marci O’Doherty and she oversees 45 women who
convert the containers into beautiful bassinets, and each one comes with two
hand-made receiving blankets and a hand-knitted hat, booties and blanket They are
given out at Naples Community Hospital, The Birth Place, upon discharge if the
need exists. It is imperative that all discharge nurses ask "where is your
newborn going to sleep?" We ask about car seats, and we tell them to place their
infants on their backs to sleep, but we have failed to ask this vital question.
The CPSC recommends that health-care providers use its recommendations to
educate parents about the danger of placing infants to sleep in adult beds. They
are as follows:
Children younger than 2 years should sleep in cribs that meet the Federal
safety standards and industry voluntary standards.
Children younger than 2 years of age, or disabled children whose movements
are restricted, should not be put to sleep in adult beds (including water beds)
that present a risk of entrapment between the bed mattress and a wall,
headboard, side railings or adjoining furniture.
Children younger than 2 years or those with disabilities whose movements are
restricted, should not be put to sleep in adult beds with railings (headboard,
footboard or side railings) that present a risk of strangulation by head
entrapment.
In some cultures sleeping with the newborns is practiced. This is common in
some Mexican and Southeast Asian cultures where this is the norm. The subject
of co-bedding is packed full of emotion. Nurses have an obligation to stress
that co-bedding significantly increases the risk for death of a precious
newborn. If families still insist on this practice, the Academy of Pediatrics has a
recommended list of guidelines printed in August 1997:
1). Unless otherwise directed by a physician, healthy newborns should be
placed down to sleep supine in a crib that meets safety standards or a bassinet. It
’s known as "BACK TO SLEEP."
2). If Mothers choose to sleep in the same bed with their infants, care
should be taken to avoid using soft sleep surfaces. Quilts, blankets, pillows,
comforters or other similar soft materials should not be placed under the infant.
3). The bedsharer should not smoke or use substances such as alcohol or drugs
which impair arousal. Sixty percent of infants who die from SIDS have been
exposed to smoking, either before and/or after delivery. The accidental death of
a newborn will have a catastrophic affect on the entire family. The guilt
will be forever. The statistics clearly indicate the dangers of bedsharing. Cribs
and bassinets are the only safe place for a baby to sleep until 2 years of
age. They are designed to meet specific safety standards.
In Collier County, approximately 16,000 farm workers reside between the
months of October and May. Poverty is widespread. Many of the workers and their
families live in small quarters, often times sharing a trailer. There is no room
for a crib. The family often has a small room, which fits only a single
mattress on a concrete floor where the entire family sleeps. Our Moses bassinet not
only provides the baby with a safe place to sleep, but it is one of the few
things that always brings a smile to appreciative faces. At the end of 1999, we
had distributed 99 Moses bassinets. We were all amazed at the need. We have a
large county, 2025 square miles, so this also accounts for the large need
here. The year 2000 ended with 106 bassinets being distributed, and this year we
surpassed that with 160. To date, we have given out over 425 since Project
Moses started in March 1999.
This project can be started very easily in any community that has a need. The
Catholic Council of Women has taken it nationally. The containers can be
purchased at cost by calling a Rubbermaid distributor (Springfield Corp.,
1-800-241-2181 ext. 111, Mark Douglas, is one contact). You must state they are for
Project Moses.
Editor’s Note: For additional information the author can be contacted at
[log in to unmask]
About the Author
Carol M. Tighe, RNC, CCE is a certified registered nurse working in Naples
Florida on the maternal-child team for Naples Community Hospital, Community Home
Services. She was formerly charge nurse of the Atlantic City Medical Center
NICU from 1973 to 1984. She was certified in 1978 by A.N.A.-N.C.C. for
excellence in maternal-gynecological-neonatal nursing in 1978. She has published three
articles on Project Moses and the dangers of co-bedding.
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