10-Fold Increased Risk of a Repeat Unexpected Infant Death in a Family Interview with:

Dr Joanna Garstang Consultant Community Paediatrician / Designated Doctor for Child Death Allenscroft Children's Centre Kings Heath, Birmingham UK

Dr. Garstang

Dr Joanna Garstang
Consultant Community Paediatrician / Designated Doctor for Child Death
Allenscroft Children’s Centre
Kings Heath, Birmingham UK What is the background for this study?

Response: Each year in England and Wales there around 3-400 babies die unexpectedly, in many cases the cause of death remains unexplained and these deaths are called Sudden Infant Death Syndrome (SIDS). Parents are understandably anxious about the risks for future children, the Care of Next Infant (CONI) programme was set up to offer support for families. In this study, we looked at records of families registered with CONI between 2000-2015 to determine the frequency and causes for repeat unexpected infant deaths. What are the main findings?

Response: The risk of a repeat unexpected infant death in a family, is 3.93 per 1000 live births which is  ten times higher than the risk of a first death in the general population. However, repeat deaths are very rare, there were only 29 deaths from 6608 infants registered with CONI during the years 2000-15. 26 families had 2 deaths, and 3 families had 3 deaths.

Most deaths were of natural causes, but many deaths occurred in unsafe sleep environments where infants were sharing beds or sofas with parents who had been drinking alcohol or using illicit drugs. Most mothers were smokers.  Child safeguarding concerns occurred in nearly half of families with more than one death. What should readers take away from your report?

Response: Families who have experienced an unexpected infant death are really vulnerable; they need help and support with subsequent infants, to address SIDS risk factors such as smoking and unsafe sleep environments. It is also really important that all unexpected infant deaths are fully investigated, so that parents have detailed information about their child’s death. What recommendations do you have for future research as a result of this work? 

Response: It is important to keep monitoring rare situations such as these, as SIDS rates have declined dramatically this becomes very difficult. There is now a National Child Mortality Database in England collected information on all child deaths, which may be able to direct future research; international collaborations will also be vital. Is there anything else you would like to add?

Response: CONI is supported by the Lullaby Trust, who provided some financial support for the project, but the Lullaby Trust had no role in study design, data collection, data analysis, data interpretation, or writing of the report. 


Recurrent sudden unexpected death in infancy: a case series of sibling deaths, Archives of Disease in Childhood (2020). DOI: 10.1136/archdischild-2019-318379



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Jun 12, 2020 @ 12:51 am


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