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What is cot death?

By Dr Ananya Mandal, MD

Cot death or crib death is sudden and unexpected death of a baby within 1 year of age.

In most cases the reasons for death after a post-mortem examination remain unexplained and the death may be registered as sudden infant death syndrome (SIDS), sudden infant death, or sudden unexpected death in infancy (SUID). (1-4)

Definition of cot death

Cot death is defined as, “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 (post mortem examination), examination of the death scene, and review of the clinical history.” (4)

Causes of cot death

While no specific causes for the condition is known, there is intense research that has shown a number of different possible causes for the deaths.

There is a likely combination of factors that affect babies at this vulnerable stage of their development.

According to experts SIDS occurs at a particular stage in a baby’s development.

Those vulnerable to certain environmental stresses including being born prematurely or to low birth weight are at higher risk.

Environmental stresses include tobacco smoke, suffocation in bedding, minor illness or having a breathing obstruction.

It is found that babies who die of SIDS or who are at greater risk for cot deaths respond differently to these stresses.

Their heart rate, breathing and temperature reacts differently than babies at a lower risk. (1-4)

Who is at risk of cot death?

Babies under the age of six months are at the greatest risk and the deaths may occur not only in the crib but anywhere else.

The occurrence of SIDS is rare during the first month after birth. The incidence and risk increases to a peak between 2 and 3 months of age, and then decreases.

About 300 babies aged under one die each year in the UK.

Trends show that male babies, premature babies and those of low birth weight and those of parents who smoke are at a higher risk.

However, SIDS is rare and the risk of a baby dying from it is low. (1, 4)

Prevention of cot death

Prevention entails:

  • placing babies on their backs to sleep,
  • avoidance of smoking by both parents during pregnancy and after delivery,
  • avoidance of baby getting too hot,
  • keeping the baby’s head uncovered,
  • avoidance of falling asleep with the baby in the couch or sofa etc.

Same safety measures are to be adopted each time the baby is put to sleep.

Smoking during pregnancy for example makes the baby four times more likely to die from cot death.

Babies exposed to a smoky environment after they are born are up to eight times more likely to die from cot death compared to a baby living in a smoke-free environment. (1, 2)

Support for parents

If a baby has died of cot death, it is important that parents seek help and support.

There has to be an investigation looking at how and why the baby died conducted by a coroner (a judicial officer).

In most cases a post-mortem examination may be necessary. This can be very distressing and upsetting for the bereaved family especially parents.

The Foundation for the Study of Infant Deaths (FSID) provides help, advice and support for bereaved families. (2, 3)

Edited by , BA Hons (Cantab)

Further Reading

Causes of cot death
Frequency of cot death
Coping with cot death
Prevention of cot death

Last Updated: Jul 2, 2012

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