Learning portal
For enrolled learners, faculty, and partner sites
Enter the password from your welcome email. Lessons, slide decks, handouts, and post-tests are inside.
This lock is a courtesy, not security. Before launch the host must protect this folder (see CLAUDE.md). Nothing confidential belongs here until then.
CHW 103: Health Across the Lifespan
103.10 Newborns, Infants and Young Children
Safe sleep, feeding, warning signs, milestones, vaccines and lead
Your materials
Slides (PowerPoint) Handout (Word)
For instructors
Facilitator guide Printable pre and post tests Quiz (LMS import)
What you will learn
- Teach the ABCs of safe sleep and safe feeding basics
- Recognize infant warning signs that need a provider or 911
- Use milestone checklists and refer families to Help Me Grow
- Support families on vaccines and lead testing within CHW scope
Start here
Think of a new parent you know. Who helped them in the first weeks home, and what help mattered most?
Lesson
Why the first year matters in Ohio
- 13.4 Black infant deaths per 1,000 births in Ohio, 2022
- 5.7 White infant deaths per 1,000 births in Ohio, 2022
- 44th Ohio's rank among 50 states for infant mortality
Source: Health Policy Ohio, citing CDC and Groundwork Ohio
The ABCs of safe sleep
Every sleep, every nap, until the first birthday:
- Alone: Baby sleeps alone, with no people, pillows, blankets, bumpers or stuffed animals in the sleep space.
- Back: Always place baby on the back to sleep, including naps, until age one.
- Crib: A firm, flat crib or bassinet with a fitted sheet. Never a couch, sofa cushion or adult bed.
- Room share: Keep baby's crib in the parents' room for at least 6 months, ideally the first year. Share the room, not the bed.
Feeding: support and safety
Supporting breastfeeding
- Experts advise only breast milk for about the first 6 months
- Breastfeeding can continue to age 2 or longer
- Connect parents to WIC breastfeeding peer helpers
- Respect each family's choice without shame
Formula safety
- Wash hands and follow the label for water and powder
- Never add extra water to stretch formula
- Use within 2 hours, or 1 hour after feeding starts
- Refrigerate unused bottles and use within 24 hours
- Never warm bottles in a microwave
Infant warning signs and what to do
| What you see | What to do |
|---|---|
| Baby under 3 months with fever 100.4 F or higher | Call the baby's provider now or go to the ER |
| Not breathing, limp, will not wake, or a seizure | Call 911 |
| Trouble breathing or skin or lips turn blue | Go to the ER right away |
| Not eating well or a change in wet or dirty diapers | Help the family call the provider today |
| Parent worried something is wrong | Take it seriously; connect to the provider |
| Any of the above | Document and tell your supervisor |
Milestones and the Help Me Grow referral
- Use the CDC checklists: Free milestone checklists cover 2 months to 5 years. The Milestone Tracker app is free too.
- Talk with the doctor: Bring the checklist to well-child visits and ask about developmental screening.
- Under age 3: Help Me Grow: Refer to Ohio's Help Me Grow for a free Early Intervention evaluation. Anyone can refer.
- Age 3 and up: school: Contact the local public school district for a free evaluation.
- Do not wait: Acting early makes a real difference. Waiting to see often loses precious time.
Vaccines and lead testing
- Vaccines protect: Help families keep shot records and get to well-child visits. Questions about which shots go to the provider.
- Ohio school rules: Kindergarten requires DTaP, polio, MMR, hepatitis B and chickenpox shots, with medical or conscience exemptions.
- Lead testing: Ohio requires lead tests at ages 1 and 2 for children on Medicaid and in high-risk ZIP codes.
- Old housing: Homes built before 1978 may have lead paint. There is no safe level of lead in blood.
Upstream: lead in a child's blood
- What we see: Two-year-old Jaylen in Hough has a high lead level. His mom feels guilty and scared.
- Why it happens (upstream): Old rental housing built before 1978, peeling paint, slow repairs, and decades of disinvestment in his neighborhood.
- What we can build on (assets): His pediatrician, the health department, Help Me Grow, city lead-safe programs, tenant groups, and a grandmother who helps with cleaning.
Situation: the tired dad on the couch
Situation: On a home visit in Glenville, you find Marcus asleep on the couch with his 3-week-old daughter on his chest. He wakes up and says it is the only way she sleeps, and he works nights.
What do you say and do?
- Stay calm and kind; he is doing his best
- Explain why couches are dangerous for sleeping babies
- Ask about the crib and help find one if needed
- Plan with him for safe sleep when he is exhausted
Talk it over
- What safe sleep advice did your family pass down, and how do you honor it while teaching ABCs?
- What gets in the way of well-child visits in our neighborhoods?
- Who in our community already helps new parents?
Study sheet
The big idea: We keep babies safe by teaching safe sleep and feeding, acting fast on warning signs, and connecting families to early help.
Key points
- Safe sleep ABCs: alone, on the back, in a crib, every sleep until the first birthday.
- Share the room, not the bed. Couches are especially dangerous for sleeping babies.
- Make formula exactly as the label says, never watered down, and never warmed in a microwave.
- A fever of 100.4 F or higher in a baby under 3 months needs the provider or ER right away.
- For developmental concerns, refer children under 3 to Help Me Grow and older children to the school district.
- Ask if young children have had lead tests, especially in homes built before 1978.
Remember
- ABCs: Alone, Back, Crib
- Under 3 months: fever 100.4 F or higher is urgent
- Formula: use within 2 hours, fridge up to 24 hours
- Lead tests at ages 1 and 2 for children on Medicaid
- Not breathing, limp or will not wake: call 911
Ask yourself
- How can I teach safe sleep without shaming a tired parent?
- Which upstream problems in my neighborhood put babies at risk?
- Who would I call first to refer a toddler for an evaluation?
Vocabulary
| Word | What it means |
|---|---|
| Infant mortality | The death of a baby before their first birthday, usually counted per 1,000 live births. |
| Safe sleep | Putting a baby to sleep alone, on the back, in a crib, to lower the risk of sleep-related death. |
| Room sharing | The baby sleeps in their own crib or bassinet in the parents' room, not in the parents' bed. |
| Exclusive breastfeeding | Feeding a baby only breast milk, with no formula, water or food. |
| Infant formula | A manufactured food made to feed babies, mixed or served exactly as the label says. |
| Developmental milestone | A skill most children can do by a certain age, like smiling, waving or walking. |
| Early Intervention | Free Ohio services for children birth to age 3 with developmental delays or disabilities. |
| Help Me Grow | Ohio's program that connects families to Early Intervention, home visiting and screening. |
| Immunization | A vaccine that trains the body to fight a disease before a person catches it. |
| Exemption | A written reason, medical or of conscience, that excuses a child from a school vaccine requirement. |
| Blood lead test | A blood test that shows how much lead is in a child's body. |
Real-life situations
Stretching the formula
Ms. Alvarez in Clark-Fulton is raising her infant grandson. She tells you she adds extra water to his formula so the can lasts until payday.
What to do
- Thank her for telling you, and do not shame her
- Explain simply that extra water can harm a baby's kidneys and growth
- Help her apply for WIC and connect her to a food pantry today
- Encourage her to tell the baby's doctor, and tell your supervisor
Why: Watering down formula is a sign of an upstream money problem. The CHW answer is safety teaching plus fast resource connection.
Not talking yet
Keisha in Slavic Village says her 2-year-old son uses only a few words. Her aunt told her boys talk late and not to worry.
What to do
- Listen and respect both Keisha and her aunt
- Go over the CDC milestone checklist for 2 years together
- Explain that Help Me Grow gives free evaluations for children under 3
- With her permission, help her complete the referral and tell the child's doctor
Why: Acting early on a possible delay helps the child most, and Early Intervention is free.
Unsure about shots
Ahmed in Lakewood says he has heard that the government changed the vaccine schedule and he does not know what to believe for his 1-year-old.
What to do
- Listen to his concerns without arguing
- Say honestly that schedules have been in the news and in court
- Encourage him to bring his questions to the child's pediatrician
- Help him get a copy of the child's shot record
Why: Vaccine choices belong to families and providers. CHWs build trust and connect families to reliable care.
A toddler and peeling paint
On a visit in East Cleveland, you notice paint chips on the windowsill where 18-month-old Nia plays. Her mom is not sure Nia has had a lead test.
What to do
- Share that old paint can contain lead and that tests are simple
- Help the family schedule a lead test with Nia's provider
- Share how to wet-wipe sills and wash hands and toys often
- Connect the family to the health department and any housing help, and tell your supervisor
Why: There is no safe level of lead in blood. Testing finds it early, and housing help fixes the source.
Activity: Build a new family resource card
About 25 minutes.
- Make a one-page card for new parents in your neighborhood.
- Include the safe sleep ABCs and the infant fever rule in plain words.
- Add how to reach Help Me Grow, WIC, and the place families can get a crib or lead test locally.
- Check that every phone number and website on your card is current.
- Share your card with a partner and give each other one suggestion.
Post-test
Ten questions. You need 75% to pass, with one retake. Your result is saved in this browser.
Sources
- Health Policy Ohio, Ohio making strides in infant mortality but racial disparities persist (2024)
- News 5 Cleveland, Black infants continue to die at a higher rate in Cuyahoga County (2020)
- Vanderbilt University Medical Center, Safe Sleep Practices for Infants (AAP guidance)
- CDC, Breastfeeding Recommendations and Guidance
- CDC, Infant Formula Preparation and Storage
- MedlinePlus, When your baby or infant has a fever
- CDC Learn the Signs. Act Early., Milestones Matter
- Ohio Department of Children and Youth, Help Me Grow referral
- Congressional Research Service, The 2026 Childhood Immunization Schedule
- Medical Daily, Pediatricians' lawsuit paused ahead of October 6 appeals argument (Sept 2026)
- Ohio Department of Health, 2026-2027 Kindergarten Immunization Survey Worksheet
- Ohio Department of Health, Lead Testing Requirements (via Buckeye Health Plan)
- Ohio Department of Health, Prevent Childhood Lead Poisoning
- AWHONN, Newborn Warning Signs handout (2026), via CMQCC
- Gallia County Health Department, Ohio WIC Breastfeeding Awareness Month (breastfeeding peer helpers)
- Georgetown Law Litigation Tracker, AAP v. Kennedy (status: briefing ongoing, updated October 7, 2026)
- CDC, Childhood Lead Poisoning Prevention: Ohio (updated August 27, 2026)