Distinguishing Sudden infant death syndrome from child abuse fatalities

• Published in: Pediatrics (Evanston) 1994-07, Vol.94 (1), p.124-126
• Main Authors: Krugman, Richard D, Bays, Judith Ann, Chadwick, David L, Kanda, Mireille B
• Format: Article
• Language: English
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Child abuse; Child abuse & neglect; Diagnosis; Emergency and intensive care: neonates and children. Prematurity. Sudden death; Infant mortality; Infants; Intensive care medicine; Medical sciences; Mortality; Patient outcomes; Pediatrics; SIDS; Sudden infant death syndrome
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.94.1.124

Public and professional awareness of sudden infant death syndrome (SIDS) has increased in the 28 years since the establishment of the National Sudden Infant Death Foundation, now called the National SIDS Alliance.1 Similarly, awareness of child abuse has increased in the 30 years since the publication of the first article on the battered child.2 In the majority of cases, when an infant younger than 1 year dies suddenly and unexpectedly, the cause is SIDS. Sudden infant death syndrome is far more common than infanticide. In a few difficult cases, legitimate investigations for possible child abuse have resulted in an insensitive approach to grieving parents or caretakers. This statement provides professionals with information and guidelines to avoid distressing or stigmatizing families of SIDS victims while allowing accumulation of appropriate evidence in the uncommon case of death by infanticide. INCIDENCE AND EPIDEMIOLOGY Sudden infant death syndrome, also called crib or cot death, is "the sudden death of an infant under 1 year of age which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and a review of the clinical history." 3 Sudden infant death is the most common cause of death between I and 12 months of age. Eighty percent of cases occur before age 5 months, with a peak incidence between 2 and 4 months of age. Sudden infant death syndrome occurs in 1.5 to 2 per 1000 live births, resulting in 6000 to 7000 infant deaths each year in the United States.4