By Dr Ananya Mandal, MD
Cot death or Sudden Infant Death Syndrome is unexplained death of an infant. The period right after the death and long after the event may be deeply distressing.
However, important decisions need to be made by the parents during this time. (1-4)
Confirming the death of the baby
Parents need to immediately notify a doctor or other health professional to confirm the death of the baby.
If the cause is uncertain, the Coroner (judicial officer) must be informed.
The Coroner’s duty is to inquire into sudden unexpected deaths to find out the cause and circumstances of the death. This might mean an informal inquiry or an inquest.
In most cases the Coroner is likely to arrange for a post mortem examination.
The post mortem occurs at the mortuary where a specialist paediatric pathologist carries out the examination.
The baby’s death should be registered if there is to be no inquest. The Coroner’s Officer or other official may advise parents when to register.
If no cause of death is ascertained the Coroner will confirm the cause as SIDS. Once the examination is completed funeral may be organized.
Coping with grief
Greif after loss of a baby is intense with an overwhelming feeling of loss and self-blame.
There may be confusion, anger, difficulty concentrating and physical problems like lack of appetite and sleep problems.
Most parents keep going over and over on what they did or did not do.
There may be periods of anger on spouse, doctor, health visitor or anyone else. These feelings of guilt and blame are normal and part of the bereavement process.
Returning to work or care of the surviving siblings is a difficult and seemingly daunting task that needs family support and help.
There is also a risk of fears for future tragedies. Some parents may develop problems with their relationships and suffer depressive bouts or have suicidal thoughts.
These need addressing by support groups.
Helping siblings cope
It is important to help siblings cope with a crib death. Brothers and sisters, however young, should be involved so that they can participate in the ceremony and say good-bye.
In case of death of a twin it is important that the surviving twin undergoes check-ups for prevention of a recurrence.
Parents are often anxious about how their other children will be affected by the baby’s death.
If the surviving sibling is older, the death needs to be explained gently to him or her.
The child might suffer from similar feelings of guilt, loss and grief as an adult.
It is important that the child is reassured that it was not anybody’s fault that the baby died.
The child should be encouraged to talk and express their feelings.
Patience, listening, sharing tearful times and sadness with the child helps the child cope better.
Memories of the lost sibling may be shared by looking at photographs and remembering events.
The child’s playgroup leader or school teacher needs to be informed about the event.
Having another baby
The decision to have another baby is a very personal one. It is helpful to discuss further children with a doctor or paediatrician.
Most parents are counselled that no baby can replace another and seeking the lost baby in others is a futile and often heart breaking exercise.
Advice and support for parents
The Foundation for the Study of Infant Deaths (FSID) provides help, advice and support for bereaved parents and families.
Other organizations include:
Edited by April Cashin-Garbutt, BA Hons (Cantab)
What is cot death?
Causes of cot death
Frequency of cot death
Prevention of cot death