HEALTH

COT DEATH



Provided by Foundation for the study of Infant Deaths

What is cot death?
Cot death is the sudden and unexpected death of a baby for no obvious reason. The post-mortem examination may explain some deaths. Those that remain unexplained after post-mortem examination may be registered as sudden infant death syndrome (SIDS), sudden infant death, sudden unexpected death in infancy or cot death.
What causes cot death?
No one knows yet why these babies die. Researchers think there are likely to be a number of different causes, or that a combination of factors affects a baby at a vulnerable stage of development.
Do babies only die at night in their cots?
No, cot deaths can occur anywhere and at any time. Some babies die in their parents' arms or in a pram, but babies are usually found dead in their cots.
Do babies suffocate?
Babies who die as cot deaths often appear to have died of suffocation. They may be found face down or with their faces covered. However, it is very rare that suffocation is the actual cause.
Do babies suffer any pain?
No. Most die peacefully in their sleep without pain or distress.
Does it only happen to certain babies?
No. Cot death can affect any baby, but certain babies are more at risk, namely boys, premature and low birth-weight babies. For example, 60% of cot deaths in England and Wales occurred among boys, while they comprised 51% of all live births (figures refer to babies aged birth to one year, 1994-1998).
In 1998 in England and Wales, 89% of cot deaths occurred in babies aged under six months, with a peak at two-three months. The risk reduces as babies get older. 3.7% of babies who died of cot death were aged over one year.
Does cot death only happen in certain families?
Cot death can happen to any family, though it is more likely to happen in families living in difficult circumstances. At present, the incidence of cot death appears to be lower amongst Asian families, but because of the number of factors associated with cot death, no one knows why this is.
Does cot death run in families?
No, less than 1% of cot deaths are due to an inherited disorder, such as an enzyme deficiency. It is very rare for cot death to occur twice within the same family.
Why are the police involved?
The law requires that a coroner investigates all sudden and unexpected deaths in infants (and adults) to certify the cause of death. The coroner's representative, usually a police officer, will ask the parents for information. The police are authorised to investigate unexpected deaths and they could visit, take photographs and perhaps remove the baby's bedding.

Is there any support for parents who have had a cot death and are having another baby?
Yes. The Care of the Next Infant (CONI) programme, run by FSID in conjunction with the NHS, offers advice, support and practical help to cot death parents in the care of their next baby. This programme is also available to families whose babies have died for other reasons, the extended families of cot death babies, and parents of babies who have experienced Apparent Life Threatening Events (ALTEs). Ring FSID's 24 hour helpline on 020 7233 2090 for more information about the CONI programme.
What research is being done?
Most of the research into cot death in England and Wales has been funded by FSID. Since it was founded in 1971, FSID has spent over £8 million on research. All research funded by FSID is rigorously assessed by independent scientists and doctors. We believe that, in order to reduce the rate of cot death further, we need to understand what makes babies healthy. Research currently being funded is looking at:
· How babies cope living in difficult circumstances.
· Interactions between parents and their babies when room sharing or bed sharing.
· How physiological control mechanisms are influenced by age, sleep position, passive smoking and other risk factors.
· What influences parents in making baby care decisions.
· Antenatal and postnatal physiological development of babies born to mothers living in difficult circumstances and how this affects mother/infant interaction.
· Ways to reduce babies' exposure to passive smoke.
· Airway function in low birthweight infants.
· Identifying new risk factors for the prevention and reduction of cot death.
Is cot death on the decline?
The rate remained fairly constant in England and Wales at about two per 1,000 live births from 1971 to 1988, and then began to decline. The rate has fallen by 69% since the reduce the risk campaign was launched in 1991. However, 7 babies still die as cot deaths every week in the U.K.
How does cot death compare with other childhood problems?
Cot death remains the most common kind of death in babies aged under one year. In 1998, the number of cot deaths was over two and a half times that of the number of babies under one year) who died of leukaemia or of meningitis.
Cot death and other conditions
England & Wales 1998. All 28 days to one year. * (Source:ONS)
* latest available data.
How does Britain's cot death rate compare with other countries?
It is similar to countries such as Australia, Canada and the Netherlands. The rate is lower in Sweden and Hong Kong, but higher in New Zealand and the USA. In recent years the rate in many industrialised countries has declined, as in the UK, following the introduction of Reduce the Risk campaigns.
At what time of year do cot deaths occur?
Cot deaths used to happen more often in the winter, but this winter peak has almost disappeared since the Reduce the Risk campaign.




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