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Last Updated: Wednesday, 10 December, 2003, 15:04 GMT
Most cot deaths due to 'natural causes'
Baby lying on its back
Parents are advised to put babies to sleep on their backs
Doctors continue to investigate exactly what causes cot death, but say the majority of cases are due to natural causes.

Each year, around 600 babies die in England and Wales between one week of age and their first birthday.

That works out at around one baby in every 1,600 dying of cot death each year.

Around ninety per cent of deaths occur in babies aged under six months.

Unfortunately, there is a current eagerness by some to view all sudden and unexpected deaths with suspicion, particularly where there is a second death in the family
Joyce Epstein, Foundation for the Study of Infant Deaths
Boys appear to be at a slightly higher risk.

In around half of cases, a cause of death cannot be found at the post mortem, and they are registered as having died of Sudden Infant Death Syndrome (SIDS).

It is still the most common cause of death in young babies.

'Back to sleep'

Cot death kills more babies each year than road accidents, leukaemia and meningitis put together.

But very little is known about what causes healthy babies to die so suddenly.

However, the number of babies dying as a result of cot deaths in the UK has fallen by nearly 70% since the introduction of initiatives to cut risk factors in the early 90s.

The campaign to encourage parents to put their babies to sleep on their backs is credited with significantly cutting deaths.

However, certain risk factors mean a baby is at a higher risk of cot death than if they are not present.

If the mother is under 27 and has more than one previous child, and if both parents are unemployed and are smokers, the likelihood of a cot death is around one in 200.

If none of these factors apply, then the likelihood is far less, around one in 8,5001.

The Foundation for the Study of Infant Death (FSID) advises that parents can reduce the risk of cot death by : -

  • Stopping smoking
  • Not letting anyone smoke near the baby
  • Placing the baby on its back to sleep
  • Not letting the baby get too hot
  • Keeping the baby's head uncovered
  • Keeping the baby in their bedroom for the first six months
  • Not sharing the bed with your baby if either parent smokes, has been drinking or takes medication or drugs which make them feel drowsy or tired
  • Not sleeping with the baby on the sofa
  • Seeking medical advice promptly if the baby appears to be unwell.

Social factors

Research suggests that maltreatment, such as negligence, very poor care or deliberate harm, is a factor in around 10% of cases.

FSID says such cases may be regarded as more commonplace than they are because of the media attention paid to them.

If one cot death has occurred in a family, there is a higher than average risk of a second baby also dying from the condition.

This could be because the same social and environmental factors that were present for the first baby who died are present for subsequent babies.

Other factors, such as congenital abnormalities, accidents or infections or undiagnosed medical conditions which run in the family such as metabolic abnormalities and heart defects may also increase a family's risk.

The FSID says, although the unexpected death of a second baby must always give rise to serious concern, the number of cases where there is maltreatment or child abuse is very small.

'Hurtful'

Joyce Epstein, director of FSID, said: "If a child dies suddenly and unexpectedly the risk of it happening again in the same family does increase.

"The reasons for this are varied and range from metabolic disorders to environmental and social factors. Certainly second cot deaths can be true cot deaths, where all other causes have been excluded. "

She added: "FSID has evidence that second cot deaths occur roughly once a year.

"Unfortunately, there is a current eagerness by some to view all sudden and unexpected deaths with suspicion, particularly where there is a second death in the family.

"This is very hurtful to the thousands of innocent bereaved families. Instead, what is needed is careful and expert examination of all infant deaths, at the time of the death - a goal which FSID is campaigning for."


SEE ALSO:
Mother cleared of killing sons
10 Dec 03  |  Wiltshire
Babies 'had higher cot death risk'
09 Dec 03  |  Wiltshire


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