The death of a newborn or infant is always a heartbreaking tragedy, especially as we search for reasons why or things we could have done differently. The departments of Human Services (DHS) and Health (DOH) ask parents to sit down and have an open conversation about safe sleep with the people who care for your children before tragedy occurs.

The devastation of sudden unexpected infant death (SUID), also known as sudden infant death syndrome (SIDS), can occur when babies are asleep for reasons that may or may not be known. We do know that many sleep-related infant deaths occur from suffocation when infants are sleeping in a face-down position, and suffocation is the leading cause of fatal injuries among Hawaii infants from newborn to one year old.

Our departments believe we can help prevent these tragedies by talking with each other, and especially our children’s caregivers, about the best evidence and safety practices available when it comes to safe sleeping.

Late last year, the American Academy of Pediatrics (AAP) updated recommendations on safe sleep for infants. Among their recommendations is advice for doctors to “have open and nonjudgmental conversations with families about their sleep practices.” We believe it’s time not just for doctors to have these kinds of conversations, but also families to have them with anyone who cares for their children.

When you have these conversations, remember that safe sleep practices include:

>> Placing infants on their back to sleep, even for naps;

>> Placing infants to sleep in safety-approved cribs with firm mattresses and covered by a fitted sheet;

>> Keeping your car and home smoke-free;

>> Keeping pillows, soft comforters, crib bumpers and stuffed toys out of the sleep area; and

>> Preventing overheating — Do not overdress infants when they sleep.

Ask prospective care providers or babysitters about how they put infants to sleep and how they supervise infants while they are asleep. DHS-licensed or registered providers are required to provide you copies of their safe sleep practices at the time of enrollment. They must also follow safe sleep best practices and safe sleep-specific rules DHS promulgated this spring, which, among other things, requires providers (and all employees, volunteers and adult household members) participate in initial and annual safe sleep training. You should also know that you have the right to inspect the premises and the places where your child care provider will put your keiki to sleep.

Be fearless in having this conversation with providers. If you have questions or concerns about your regulated child care provider, contact your local DHS child care licensing unit.

Our departments also know that we rely frequently on friends and family, often our elders, to care for our children. We recognize our island culture of respecting kupuna and not questioning their guidance. So in these instances, we recommend using the AAP’s guidance and keeping your conversation open and nonjudgmental.

The Departments of Health and Human Services and our partners in the Keiki Injury Prevention Coalition encourages everyone to check out “What You Can Do to Protect Your Keiki.” This guide provides important safety tips for caregivers and families of children from birth to age 18. This guide and other potentially lifesaving information can be found at www.kipchawaii.org and www.safesleephawaii.org. Both the Keiki Injury Prevention Coalition and Safe Sleep Hawai‘i can help you with having conversations about safe sleep with caregivers and loved ones.

We believe we can keep our keiki safe when they sleep no matter who is caring for them. Let’s have a collective conversation about how we put babies to sleep and not let a single child be silenced by our own silence.

Pankaj Bhanot is director of the state Department of Human Services; Dr. Virginia Pressler is director of the state Department of Health.