May/June 2001Vol. 2, No. 3Pediatricians Urge Closer Scrutiny of SIDS Cases
New guidelines released by the American Academy of Pediatrics in February acknowledge that some infants whose deaths are attributed to Sudden Infant Death Syndrome (SIDS) might actually have been murdered.
While the AAP has long recommended death-scene investigations and autopsies for all SIDS cases, the new guidelines urge that the autopsy be performed by a child abuse specialist, or that a pre-autopsy examination be performed by a specialist.
These new guidelines respond to several recent, highly publicized cases in which infants whose deaths were attributed to SIDS were later found to have been suffocated by their parents. Researchers estimate that up to 5 percent of deaths attributed to SIDS may be infanticide. While it is nearly impossible to distinguish at autopsy between SIDS and accidental or deliberate asphyxiation with a soft object, AAP urges physicians to be alert to incidents in which:
- An infant was 6 months or older
- The infant had one or more siblings who died unexpectedly or under unexplained circumstances
- Twin infants died simultaneously
- Blood is found on the infant's nose or mouth.
"What we really want physicians to understand is that SIDS represents an admission by medical professionals that a thorough and exhaustive search for any other cause of death has occurred," said Dr. Kent Hymel, a member of the Academy's child abuse committee. "What's frightening is that in some cases, that's not happening."
SIDS, also called crib or cot death, is the sudden, unexplained death of an infant under 1 year of age. SIDS cases have steadily declined since the AAP began recommending in 1994 that babies be put to sleep on their backs.
The Academy also recommends creation of locally based infant death review teams that would report their findings to the medical examiner or coroner for final review. The guidelines also stress that while an investigation is taking place, parents should be treated in a non-accusatory and supportive manner and promptly notified once the cause of death is determined.
A copy of the AAP policy statement on "Distinguishing Sudden Infant Death Syndrome From Child Abuse Fatalities," is available online at: http://www.aap.org/policy/re0036.html.
Related Item
The National Sudden Infant Death Syndrome Resource Center (NSRC) provides information services and technical assistance on SIDS and related topics. To contact NSRC call, write, or email:
National Sudden Infant Death Syndrome Resource Center
2070 Chain Bridge Road, Suite 450
Vienna, VA 22182
Phone: 703-821-8955
Fax: 703-821-2098
Email: sids@circsol.com
Website: http://www.circsol.com/sids
