Recurrent sudden unexpected death in infancy: a case series of sibling deaths

Author:

Garstang Joanna JORCID,Campbell Michael J,Cohen Marta CORCID,Coombs Robert C,Daman Willems Charlotte,McKenzie Angela,Moore Angela,Waite Alison

Abstract

ObjectivesTo determine the rate of sudden unexpected death in infancy (SUDI) for infants born after a previous SUDI in the same family, and to establish the causes of death and the frequency of child protection concerns in families with recurrent SUDI.DesignObservational study using clinical case records.SettingThe UK’s Care of Next Infant (CONI) programme, which provides additional care to families who have experienced SUDI with their subsequent children.PatientsInfants registered on CONI between January 2000 and December 2015.Main outcome measuresCause of death, presence of modifiable risk factors for SUDI and child protection concerns.ResultsThere were 6608 live-born infants registered in CONI with 29 deaths. 26 families had 2 deaths, and 3 families had 3 deaths. The SUDI rate for infants born after one SUDI is 3.93 (95% CI 2.7 to 5.8) per 1000 live births. Cause of death was unexplained for 19 first and 15 CONI deaths. Accidental asphyxia accounted for 2 first and 6 CONI deaths; medical causes for 3 first and 4 CONI deaths; and homicide for 2 first and 4 CONI deaths. 10 families had child protection concerns.ConclusionsThe SUDI rate for siblings is 10 times higher than the current UK SUDI rate. Homicide presenting as recurrent SUDI is very rare. Many parents continued to smoke and exposed infants to hazardous co-sleeping situations, with these directly leading to or contributing to the death of six siblings. SUDI parents need support to improve parenting skills and reduce risk to subsequent infants.

Publisher

BMJ

Subject

Pediatrics, Perinatology and Child Health

Reference28 articles.

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2. HM Government . Working together to safeguard children: a guide to inter-agency working to safeguard and promote the welfare of children. London: Department for Education, 2015.

3. Sudden Infant Death Syndrome and Unclassified Sudden Infant Deaths: A Definitional and Diagnostic Approach

4. Office for National Statistics . Unexplained deaths in infancy, England and Wales: 2017 2019.

5. International comparison of sudden unexpected death in infancy rates using a newly proposed set of cause-of-death codes

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