Cot death: Treatment, symptoms, advice and help

Definition
A baby is said to have suffered cot death or sudden infant death syndrome when an apparently healthy baby dies suddenly and for no obvious reason. The post mortem also finds no cause for the death so the reason for the tragic event remains a mystery.

Sadly the parents will have put to bed an apparently happy and well baby but on returning to the cot a few hours later or the next morning find their baby dead. Death happens quietly, the bedclothes are not disturbed so there has been no struggling indicating that the baby was not in distress or pain. Parents may feel terrible guilt, but there have been times when babies travelling in the car with their parents have quietly slipped away, so sometimes even if the parents are close cot death can still happen.

Incidence
Cot death occurs in infants up to the age of 12 months, but is most common in the first 6 months of life. We still don’t know all there is to know about cot death, but there are things which can influence its frequency.

The campaign, Back to Sleep, which recommends placing babies on their back or side to sleep, reduced the rate of cot death from 2 per 1,000 to 0.45 per 1,000 so reduced the rate by three quarters.

Recommendations
The Back to Sleep campaign has had the greatest effect on reducing cot death. However, there are further recommendations that are helpful. Babies who have had their baby immunisations have a lower risk than those who miss immunisations.

Your baby should sleep in your room for the first 6 months. The bedroom should be warm but not hot around 68-70°F ( 21-23°C). Babies should be wearing something like a vest and babygrow but not a hat, and covered by blankets that can be tucked in securely under the mattress. Pillows, duvets and loose bedclothes should be avoided especially if there is a chance that they could cover the baby’s head if he slipped down the cot.

Many parents will take their baby into bed with them for comfort. This is fine, but you should not have your baby in bed with you to sleep if you smoke, have been taking alcohol before going to bed, are very tired or on tranquillisers. Parents of new babies are frequently tired because of the demands of the babies and broken nights' sleep. Please do not fall asleep with your baby on a sofa or settee as this increases the chance of cot death a lot, possibly by accidental smothering.

What causes cot death?
Despite a lot of research, much funded by the Foundation for the Study of Infant Death (FSID) we still don't know much about the actual cause, although there is quite a lot of advice as to how to reduce the chances of cot death. There have been all sorts of other ideas like the fumes from old cot mattresses, but these haven't been found to be important.

There have been attempts to try to predict which groups of infants are at a high risk of cot death and so what can be done to prevent it. Unfortunately this hasn't been useful for individual babies but has produced the recommendations in this article.

Some professionals have suggested that some babies who apparently suffer cot death have been murdered by their parents. Such suggestions are obviously very hurtful to many parents, but, sadly, we know some babies are abused by their parents, sometimes to such an extent that they die. It is important that these abusing parents are detected even if the many innocent parents are upset in the process.

What about the next baby?
The next baby after a cot death is both a happy and worrying time for the parents. The organisation Care of the Next Infant (CONI) has leaflets that can be obtained from FSID below. Many of these next babies go home from hospital on a breathing alarm, ap