From
Clinician Reviews ^®

Distinguishing Crib Death From a Criminal Act

Abstract

Sudden infant death syndrome (SIDS), also known as crib or cot death, is the most common cause of death between ages one and six months. However, not all sudden and unexplainable infant deaths are attributable to SIDS. In light of well-publicized cases of attempted and successful infanticide masqueraded as apparent life-threatening events or SIDS, the American Academy of Pediatrics has published a policy statement* to establish a protocol for proper diagnosis without traumatizing the parents of true SIDS cases. [Clinician Reviews 11(5):99-100, 103, 2001. © 2001 Clinicians Publishing Group]

Introduction

According to a 1997 British study published in Pediatrics, 30 parents were caught on videotape intentionally suffocating their infants subsequent to the hospitalization of the infants for apparent life-threatening events (ALTEs).^[1] Four of those parents later admitted to killing eight of the infants' siblings whose deaths had been previously classified as SIDS. This and other highly-publicized cases have prompted the American Academy of Pediatrics to establish an infant death investigation protocol that requires cooperation among several branches of the medical community.

In general, the incidence of child abuse among purported SIDS cases can range from less than 1% to 5%.^[1,2,3-5] Failure to differentiate between SIDS and child abuse not only prevents potential criminal acts from being prosecuted, but also results in undiscovered potential health hazards and missed opportunities to better understand the etiology of SIDS.

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This article is based on American Academy of Pediatrics, Committee on Child Abuse and Neglect. Distinguishing sudden infant death syndrome from child abuse fatalities (RE0036). Pediatrics. 2001;107:437-441. The remaining references are cited in the guidelines.