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The BBC's James Westhead
"On average one child dies every day"
 real 28k

The BBC's health correspondent Richard Hannaford
"This is the largest ever study of cot deaths"
 real 28k

Professor Christopher Bacon, report co-author
"Many of the factors that we identified were things that the parents really couldn't be blamed for"
 real 28k

Wednesday, 2 February, 2000, 11:15 GMT
Many cot deaths 'avoidable'

Baby Babies should be placed on their backs to sleep


Six out of ten cot deaths could be partly caused by sub-standard care, deprived living conditions or abuse, a major report has found.

The vast majority of these cases are down to parents not following guidance on how to minimise risk.

But the researchers say that cot deaths are not investigated as thoroughly as they should be and some cases of parental abuse are being overlooked.

The researchers call on the Home Office and the Department of Health to review the way cases of cot death, or Sudden Infant Death Syndrome, are investigated by doctors and police.

They describe the current arrangements as "inadequate and in need of revision".


Other findings of the research
Many of the cot deaths had medical problems from birth
Their mothers were more likely to have had previous stillbirths or other infant deaths
Cot death rates were higher in families living in deprived conditions
There was no evidence that airline flights or mattress type or age are risk factors
Immunisation is associated with a significantly lower risk
63% of cot deaths were boys
Twins are at higher risk
The highest number of deaths took place at 13 weeks
The report, funded by the Confidential Enquiry into Stillbirths & Deaths in Infancy (CESDI), the Foundation for the Study of Infant Death (FSID) and the Department of Health, gives the findings of the largest ever study of cot deaths in the UK.

Cot death is the largest single category of deaths in babies over one month old.

The researchers found that in 60% of cot deaths, parents had failed to minimise the risk to their child.

In many cases they had ignored, or had failed to receive, advice such as laying their child on its back to sleep and not smoking.

However, undiagnosed maltreatment was probably the primary cause in 6% of cases.

Failings in the system

The study found that post-mortem investigations were not always thorough, diagnoses varied with the professionals involved, and medical and family histories which might prove important were not routinely available.

The report says: "As a result, it was believed that causes of death, both natural and unnatural, may be unrecognised.

"Parents may not be properly advised or supported, and uninformed speculation concerning maltreatment may arise."

The authors recommend that when an unexpected infant death occurs:

  • Families are visited at home with 24-48 hours by a paediatrician or other health professional, liasing with a specially trained police officer, to gather information
  • All postmortems are carried out promptly by a pathologist with specialised knowledge
  • A local case review of the death by all professionals involved in the baby's care to determine cause of death, and agree a plan to support the family

Reducing the risk
Place baby on its back to sleep
Do not smoke near baby
Do not let baby get too hot
Keep baby's head uncovered
Place baby at the foot of the cot to prevent wriggling down under the covers
Don't fall asleep on a sofa with baby
If baby is unwell, seek advice promptly

Colin Baker, FSID chairman, said: "Seven babies are still dying every week in the UK, and details about the circumstances of their deaths are not being comprehensively collected.

"We could be losing valuable information that may prevent further tragedies.

"We believe we owe it to our babies to do as much as we possibly can to try to find out why cot death is still the main cause of death in infancy."

The Community Practitioners' and Health Visitors' Association (CPHVA) hailed the report as "a milestone for saving hundreds of babies' lives a year".

CPHVA's director Jackie Carnell said: "It is a blueprint to assist health visitors in their efforts to further reduce the number of deaths in babies under one year old."

The study covered 450 babies of one week to one year old who died between 1993 and 1996 in the former NHS regions of South Western, Yorkshire, Trent, Northern and Wessex.

A total of 325 of these deaths were categorised as cot death as no cause of death could be found.

The FSID and the Department of Health are producing an updated advice booklet to be distributed to expectant parents.

The FSID says that the study was carried out before its current campaign on reducing risk had a chance to take full effect.

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Cot deaths
Are parents being blamed?

See also:
02 Feb 00 |  Health
Visits 'would help prevent deaths'
02 Feb 00 |  Health
'They thought my baby was murdered'
05 Aug 99 |  Health
Cot death rate falls
25 Feb 99 |  Health
Cot death error 'costs lives'
13 Jan 99 |  Health
Overheated blood may cause cot death
03 Dec 99 |  Health
Baby bed-sharing warning
23 Mar 99 |  Health
Many unaware smoking harms children
10 Aug 99 |  Health
Duvets 'still a cot death risk'
17 Aug 99 |  Health
Cot death diagnosis may hide suffocation

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