By Dr. Catherine Gant

Cot death is also called sudden infant death syndrome or SIDS.

It is the sudden, unexpected death of a baby less than one year for which no cause can be found at post mortem.

No cause is known. Some suggestions are brain-stem abnormalities or immaturities, which affect breathing, heart rate and temperature control. Other suggested causes include infection, reflux or over-heating. Some people have claimed links with fire-retardants on mattresses. For more information see Cot death - Foundation for the Study of Infant Deaths. Occasionally a baby thought to have died of cot death is found to have an undiagnosed heart or metabolic problem.

By definition infant death includes all deaths up to one year of age, but in reality cot death is rare after six months in babies born at term. Most cases of cot death occur between two and four months of age, so it is also rare before one month of age.

Cot death is more common in boy babies, babies who were premature, multiple births, and impoverished families.

HOW TO PREVENT COT DEATH

1.      Always lie newborn babies on their backs. This has reduced cot deaths by 70%. Once they can roll over let them choose their own sleeping position. It is also recommended that babies sleep with their feet at the end of the cot as this stops them burrowing under the bedclothes as they move down the cot at night.

2.      Don’t overwrap your baby at night. A good temperature for the bedroom is 65 degrees Farenheight (18oC). Some people think that cot death may be due to over-heating. Don’t cover your baby’s head at night.

3.      Don’t smoke during pregnancy even passively, and don’t allow people to smoke in the house after the baby is born. This includes cigars and pipes.

4.      Dress the baby warmly if you go outside in cold weather; do not allow the baby to get too cold.

ALSO try and breastfeed during these crucial months, it may help prevent infections.

Other suggestions include keeping the baby’s cot in your bedroom, not letting them sleep in your bed (there is a risk of smothering), and not going to sleep with the baby next to you on the sofa. Use a new mattress that is clean and kite-marked. Do not use duvets, pillows etc.

Baby monitors do not prevent cot death.

WHEN TO BE CONCERNED

If your baby is less than seven months old and has any of the following signs:

If your baby is pale, or cold, or hot, or having difficulty breathing, or making funny noises when he or she breathes, or if he or she is floppy, or unresponsive or much sleepier than normal, or is not feeding normally or has diarrhoea or vomiting or a high-pitched cry, then GET HIM OR HER CHECKED BY YOUR DOCTOR URGENTLY.

FURTHER INFORMATION

The Department of Health publishes a leaflet on preventing cot death in many different languages – see Reduce the Risk of Cot Death - an easy guide.

An excellent source of information is  Foundation for the Study of Infant Deaths. Support for bereaved families can be found at SANDS: The Stillbirth and Neonatal Death Society. A family that has experienced a previous cot death will need a lot of support afterwards and during later pregnancies. If you have experienced a loss you can find more information on the support available in our section on bereavement.

Also see Preventing cot death in day care.

RELATED ARTICLES

Smoking parents are a threat to children's health
Independent, 23 October 2002

Gene 'may hold clue' to cot death
BBC, 2 May 2002

Heart gene linked to cot death
BBC, 14 November 2001

Q&A: Cot Death
BBC, 25 October 2001

Hospital cot death failings
BBC, 24 October 2001

Cannabis 'increases the risk of cot death'
Independent 30 August 2001

Fathers urged to quit smoking
BBC, 9 June 2001