Statement from the Foundation for the Study of Infant Deaths on the paper by C.J. Bacon and E.N. Hey, 'Uncertainty in classification of repeat sudden unexpected infant deaths in Care of the Next Infant programme', British Medical Journal, 20 July 2007.

FSID welcomes the paper by Bacon and Hey providing an alternative analysis of the data on repeat infant deaths published by Carpenter et al in 2005(1). The Carpenter paper, like all properly written papers, includes the actual data on which the authors based their analysis of cause of death. The data are there for anyone to extract and re-interpret, and that is what Bacon and Hey have done.

FSID stresses the importance of conducting a comprehensive investigation according to a standard multi-agency protocol whenever a baby dies suddenly and unexpectedly, to learn as much as possible about the factors that contributed to the baby's death and to minimise any confusion in distinguishing between natural and unnatural death.

FSID has been campaigning for standard multi-agency investigations, with sensitive support to families, since 2000, and legislation coming into force in April 2008 will require local professionals to adopt protocols such as the one FSID has been promoting.

Bacon and Hey recommend a new category of cause of death, "undetermined", which goes against the recommendations of the 2004 report(2) of the panel of The Royal College of Pathologists and The Royal College of Paediatrics and Child Health chaired by Baroness Helena Kennedy.

References

(1) Repeat sudden unexpected and unexplained infant deaths: natural or unnatural? RG Carpenter, A Waite, RC Coombs, C Daman-Willems, A McKenzie, J Huber, JL Emery, Lancet vol 365 January 1, 2005

(2) Sudden unexpected death in infancy: The report of a working group convened by The Royal College of Pathologists and The Royal College of Paediatrics and Child Health, chaired by The Baroness Helena Kennedy QC, report published September 2004.

The Foundation for the Study of Infant Deaths is the UK's leading baby charity working to prevent sudden deaths and promote infant health. FSID funds research (nearly £10 million to date), supports bereaved families, promotes baby care advice, and works to improve investigations when a baby dies.

Advice for parents to reduce the risk of cot death:

-- Cut smoking in pregnancy - fathers too!
-- Do not let anyone smoke in the same room as your baby.
-- Place your baby on the back to sleep.
-- Do not let your baby get too hot.
-- Keep your baby's head uncovered - place your baby with their feet to the foot of the cot, to prevent wriggling down under the covers.
-- If your baby is unwell, seek medical advice promptly.
-- The safest place for your baby to sleep is in a crib or cot in a room with you for the first six months.
-- It's especially dangerous for your baby to sleep in your bed if you or your partner:
- are smokers (even if you never smoke in bed or in the home)
- have been drinking alcohol
- take medication or drugs that make you drowsy
- feel very tired;
-- or if your baby:
- was born before 37 weeks
- weighed less than 2.5kg or 5½ lbs at birth
- is less than three months old.
-- Watch out for accidents: there is also a risk that you might roll over in your sleep and suffocate your baby, or that your baby could get caught between the wall and the bed, or could roll out of an adult bed and be injured.
-- Never sleep with a baby on a sofa or armchair.

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