Child Abuse and Sudden Infant Death

Abstract

In times past, parents were usually blamed when an infant died suddenly and unexpectedly. A more caring attitude evolved with the adoption of the term ‘cot death’ or ‘sudden infant death syndrome’ (SIDS). Recent research looking at the factors responsible for SIDS has focused on aspects of child care and parental behaviour. Epidemiological studies confirm that several risk factors associated with child maltreatment are also to be found in many families who experience a sudden infant death. Social deprivation and other well-known associated features linked to maltreatment are correlated with sudden death in infancy. It is suggested that both physical abuse (suffocation is the most usual mechanism proposed) and neglect (failure to thrive, failure to recognize and treat illness) are important mechanisms. Infanticide (filicide) has existed widely over past centuries and its continuation in modern times is reflected in the highest murder rates of all age groups in infancy. However, much fatal abuse and neglect remains hidden, as demonstrated from the results of detailed fatality reviews. The evidence linking child abuse and neglect with sudden unexpected death in infancy is reviewed.