10 Sudden infant death syndrome

The loss of an infant to SIDS is a devastating experience for the family and for health providers. The physician's role is to remain informed about SIDS; to ensure that a thorough autopsy is performed in all sudden unexpected infants deaths; to see that the family is provided with accurate, appropriate information about SIDS, and to see that opportunities for ongoing support and counselling are provided. Appropriate discussions and support should be provided to all family members including the father. Current information about SIDS and local counselling and support groups can be obtained through the National SIDS Alliance (1-800-221-SIDS) in the USA and in the UK, from the Foundation for the Study of Infant Death (0171-235-0965). There are currently no tests available to accurately predict the infant who will die from SIDS. Despite much research, its precise pathophysiology remains unknown. In spite of the steady progress that has occurred in the descriptive epidemiology of SIDS, much less progress has been made in the identification of high-risk infants. It has been exceedingly difficult to find specific markers of infants that could be used in screening populations of newborns. Instead, the interventions targeted at general maternal behaviour, such as attempting to limit or stop cigarette smoking, educating mothers about the benefits of prenatal care, breast feeding and positioning their infants on their backs or sides may be the only currently available approaches.