Almost four years after Hawaii lawmakers approved a bill to assure safe sleep practices at day cares, the Department of Human Services has adopted regulations requiring infants to be placed on their backs while napping and prohibiting soft bedding and bumpers thought to pose a hazard for sudden infant death syndrome.

“I’m very happy they’re in place,” said Cynthia King, whose son Wiley died in 2014 of undetermined causes in a Kapahulu day care where, she learned afterwards, he had been sleeping in a baby bounce chair. “I’m just sorry they took so long to get there.”

In November, Civil Beat reported that the department had not yet passed the safe sleep regulations called for in Senate Bill 400, which was passed in 2013. At the time, advocates said that Hawaii was one of only seven states that had not passed such a law.

The Department of Human Services said it has already been inspecting cribs and playpens to make sure they complied with consumer safety standards. Jenca/

The DHS at first opposed the bill, arguing that safe sleep standards could better be addressed in administrative rules rather than detailed in legislation.

The department dropped its opposition after the bill’s language was amended to allow the department to write administrative rules that could accommodate any changes to evolving best practices.

The department did not write those rules until now, but officials said they have pursued policies to assure safe sleep for a decade. This included DHS licensing staff members educating day care operators about safe sleep practices during initial reviews and monitoring visits, and inspecting cribs and playpens to make sure they complied with consumer safety standards.

The department said steps such as these prevented any children from dying in licensed or registered day cares in 2016.

But at least three children died in Honolulu day cares in recent years, and parents have pointed to improper sleep practices as a factor. Experts and advocates interviewed by Civil Beat said safe sleep regulations would increase compliance and establish a standard of care.

DHS officials said in November that they were pursuing the safe sleep rules as part of a larger overhaul of child care regulations meant to comply with new federal quality and safety standards. They said a draft of those rules was not expected until the middle of this year.

But the department changed course and wrote the safe sleep rules separately. They went through a public hearing process and were adopted Friday, several months earlier than expected.

Pankaj Bhanot Ige Administration

“This department is committed to the health and safety of Hawaii’s children,” DHS Director Pankaj Bhanot said in a press release. “These rules embody our commitment by making explicit our department’s practice of requiring licensed and registered child care providers to use safe sleep best practices.”

The new rules require all of those caring for children under the age of 1 to complete safe sleep training approved by the department upon hire and each year thereafter.

Infants must be placed on their backs to sleep unless a parent has received written instructions from a health care practitioner saying otherwise. The rules require sleeping children to be monitored and periodically checked. Infants who fall asleep elsewhere must be moved to a crib or playpen.

In addition to barring soft bedding and bumper pads, the rules require tightly fitted crib sheets and well-ventilated sleeping areas for infants. They also prohibit bed-sharing, a potential cause of SIDS.

Several bills now being considered by the Legislature would require safe sleep practices. The DHS has generally opposed them, arguing that the rules it was pursuing — and that are now in place — would cover the same ground more comprehensively and make future changes possible without legislation.

About the Author