COT DEATH

Provided by Foundation for the study of Infant Deaths What is cot death? Cot death is the sudden and unexpected death of a baby for no obvious reason. The post-mortem examination may explain some deaths. Those that remain unexplained after post-mortem examination may be registered as sudden infant death syndrome (SIDS), sudden infant death, sudden unexpected death in infancy or cot death. What causes cot death? No one knows yet why these babies die. Researchers think there are likely to be a number of different causes, or that a combination of factors affects a baby at a vulnerable stage of development. Do babies only die at night in their cots? No, cot deaths can occur anywhere and at any time. Some babies die in their parents' arms or in a pram, but babies are usually found dead in their cots. Do babies suffocate? Babies who die as cot deaths often appear to have died of suffocation. They may be found face down or with their faces covered. However, it is very rare that suffocation is the actual cause. Do babies suffer any pain? No. Most die peacefully in their sleep without pain or distress. Does it only happen to certain babies? No. Cot death can affect any baby, but certain babies are more at risk, namely boys, premature and low birth-weight babies. For example, 60% of cot deaths in England and Wales occurred among boys, while they comprised 51% of all live births (figures refer to babies aged birth to one year, 1994-1998). In 1998 in England and Wales, 89% of cot deaths occurred in babies aged under six months, with a peak at two-three months. The risk reduces as babies get older. 3.7% of babies who died of cot death were aged over one year. Does cot death only happen in certain families? Cot death can happen to any family, though it is more likely to happen in families living in difficult circumstances. At present, the incidence of cot death appears to be lower amongst Asian families, but because of the number of factors associated with cot death, no one knows why this is. Does cot death run in families? No, less than 1% of cot deaths are due to an inherited disorder, such as an enzyme deficiency. It is very rare for cot death to occur twice within the same family. Why are the police involved? The law requires that a coroner investigates all sudden and unexpected deaths in infants (and adults) to certify the cause of death. The coroner's representative, usually a police officer, will ask the parents for information. The police are authorised to investigate unexpected deaths and they could visit, take photographs and perhaps remove the baby's bedding. Is there any support for parents who have had a cot death and are having another baby? Yes. The Care of the Next Infant (CONI) programme, run by FSID in conjunction with the NHS, offers advice, support and practical help to cot death parents in the care of their next baby. This programme is also available to families whose babies have died for other reasons, the extended families of cot death babies, and parents of babies who have experienced Apparent Life Threatening Events (ALTEs). Ring FSID's 24 hour helpline on 020 7233 2090 for more information about the CONI programme. What research is being done? Most of the research into cot death in England and Wales has been funded by FSID. Since it was founded in 1971, FSID has spent over £8 million on research. All research funded by FSID is rigorously assessed by independent scientists and doctors. We believe that, in order to reduce the rate of cot death further, we need to understand what makes babies healthy. Research currently being funded is looking at: · How babies cope living in difficult circumstances. · Interactions between parents and their babies when room sharing or bed sharing. · How physiological control mechanisms are influenced by age, sleep position, passive smoking and other risk factors. · What influences parents in making baby care decisions. · Antenatal and postnatal physiological development of babies born to mothers living in difficult circumstances and how this affects mother/infant interaction. · Ways to reduce babies' exposure to passive smoke. · Airway function in low birthweight infants. · Identifying new risk factors for the prevention and reduction of cot death. Is cot death on the decline? The rate remained fairly constant in England and Wales at about two per 1,000 live births from 1971 to 1988, and then began to decline. The rate has fallen by 69% since the reduce the risk campaign was launched in 1991. However, 7 babies still die as cot deaths every week in the U.K. How does cot death compare with other childhood problems? Cot death remains the most common kind of death in babies aged under one year. In 1998, the number of cot deaths was over two and a half times that of the number of babies under one year) who died of leukaemia or of meningitis. Cot death and other conditions England & Wales 1998. All 28 days to one year. * (Source:ONS) * latest available data. How does Britain's cot death rate compare with other countries? It is similar to countries such as Australia, Canada and the Netherlands. The rate is lower in Sweden and Hong Kong, but higher in New Zealand and the USA. In recent years the rate in many industrialised countries has declined, as in the UK, following the introduction of Reduce the Risk campaigns. At what time of year do cot deaths occur? Cot deaths used to happen more often in the winter, but this winter peak has almost disappeared since the Reduce the Risk campaign. Current topics Is it okay to take my baby on an aeroplane? There is no evidence that flying is unsafe for babies, if they are healthy. If you fly with your baby on either long or short flights, you should follow these guidelines: place your baby on the back to sleep, keep your baby cool, sit away from the smoking area on the plane and in the airport terminal, and make sure your baby takes appropriate feeds and doesn't become dehydrated. If you have specific questions about your baby, e.g. if your baby is unwell or has a cold, speak to your doctor before travelling. Can I use a duvet, quilt or pillow for my baby? If your baby is under one year, do not use any soft bedding, such as duvets, quilts or pillows, as they are associated with an increased risk of cot death. Instead, use one or more layers of light blankets. Don't swaddle, use electric blankets or hot water bottles. If you use a Moses basket, it should only have a thin lining. What kind of mattress should I use? It doesn't matter what kind of mattress you use, or whether it's new, as long as it is firm, not soft, doesn't sag and shows no sign of deterioration. Keep it well aired and clean. Mattresses with a PVC surface or a removable washable cover are easiest to keep clean. Ventilated mattresses (with holes) are not necessary. Place your baby with their feet to the foot of the cot. Never sleep your baby on a pillow, cushion, bean bag or water bed or sleep together with your baby on a sofa. Should I breastfeed my baby? Yes, if possible. While breastfeeding may not protect against cot death, it is the natural and best way to feed your baby and increases resistance to infections. Can my baby share my bed? It's lovely to have your baby in your bed with you for a cuddle or a feed, but put her back in the cot before you go to sleep if you or your partner smoke, have recently drunk alcohol, take drugs or are extremely tired. Keep your baby's cot in your room for the first six months as this is associated with a reduced risk of cot death. If you plan to sleep with your baby, don't let her head get covered by the duvet or pillow, do use lightweight blankets not adult bed covers, and do place your baby in a position where she cannot fall out of bed. Should my baby be immunised? Yes. Recent research shows that immunisation significantly reduces the risk of cot death. Do movement (breathing) monitors prevent cot death? Movement monitors, also known as apnoea or breathing monitors, are supposed to sound an alarm after 20 seconds if they can't detect a baby's breathing movement. They may use sensor pads attached to the tummy or housed in an elastic belt, which fits over the baby's clothing. Others use a pressure pad under the baby or an ultrasound beam. They do not monitor air flow and therefore can not detect an obstruction in the airway until breathing movements cease. Despite their widespread use there is no research evidence that monitors prevent cot death. Babies can and do die whilst on a monitor. Do dummies reduce the risk of cot death? The evidence in this area is complicated. Research suggests that babies who always use a dummy and babies who never use a dummy may be at lower risk of cot death than babies who usually use a dummy but failed to do so during their last sleep. In other words, once your baby is using a dummy regularly, this use should continue. On the current evidence, researchers do not recommend dummies to reduce the risk of cot death. Can my baby use a sleeping bag/sac? If you wish to use a sleeping bag for your baby make sure it's designed for regular use at night. It should be sleeveless without a hood, and well fitted around the arms and neck, to prevent your baby from sliding down into the bag. To make sure your baby doesn't become too hot only use a sleeping bag with a low tog rating, but check if your baby is too hot by feeling if their tummy is hot to the touch, or if they are sweating. In a sleeping bag your baby may not need any other bedding, or may need only light bedding, such as a thin blanket or sheet. Is there anything I can do to reduce the risk of cot death? Yes. There are six key steps parents and carers should take: · Place your baby on the back to sleep. · Cut smoking in pregnancy – fathers too! · Do not let anyone smoke in the same room as your baby. · Do not let your baby get too hot (or too cold). · Keep 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. How can you reduce the risk of cot death? For further information on baby health and reducing the risk of cot death contact FSID for copies of the BabyZone and Reduce the Risk booklets, or telephone FSID's 24 hour helpline on:020 7233 2090. You could also visit FSID's website which contains over 100 pages of information related to cot death, baby health and the work of FSID: www.sids.org.uk/fsid