SIDS (COT DEATH)

What is it?

Sudden infant death syndrome (or cot death) is when an infant dies suddenly and unexpectedly, and where examination of the baby's body after death does not provide an answer as to why the baby died.

What causes it?

Despite enormous amounts of research, we have still not found a single cause for sudden infant death syndrome. It seems likely there are several different causes, and that it only happens at a certain age because babies are very vulnerable to a variety of possible problems. These include getting overheated, viral infections and breathing problems. There has been some publicity about sudden infant death syndrome being used as a cover-up for parents who are smothering their own babies - but in the huge majority of cases, it is quite clear that parents are guilty of nothing more than appalling bad luck.

Who gets it?

Your baby is most at risk of sudden infant death syndrome between the ages of four weeks and four months. After this the risk starts to go down, and your baby is no longer at risk after the age of one year. Your baby is more at risk if he or she had a brother or sister who has died in the same way. The baby may also be more at risk if he or she was premature or ill just after birth. The risks are also increased by the baby being put to sleep on its front, by living in a household where adults smoke or by being kept too hot. Some children who die through SIDS have had a mild infection in the previous week but such infections are very common and there is no reliable way to predict whether having such an infection increases your child's risk.

Are there any warning signs?

Sadly, many cases of sudden infant death syndrome happen with no warning to an apparently healthy baby. In a few cases your baby may show signs of a mild cold or feverish illness in the few days beforehand.

What can be done to prevent it?

Fortunately, there is a lot that you can do to prevent this tragedy from occurring. The evidence is that fewer and fewer children are dying of cot death. In 1971 -when the condition was first described - 1 500 babies died of it one year. By 1997, that figure had gone down to 393 babies in a year. This is almost certainly due largely to a few simple measures that you as parents can take.

• Never smoke in the same house as a baby, and certainly never in the same room. You may think that only smoking in another room prevents your baby from being affected, but smoke travels and can spread through your whole home.
• Always lay your baby on its back to sleep, never on its front. Lying a baby on its side is not as bad as laying it on its front, but laying it on its back is much safer. Of course, there is nothing you can do about this once your baby can turn over from its back to its front, but by this time the main danger of cot death is past.
• Do not let your baby get too hot. It is worth investing in a nursery thermometer, which will show you both the temperature and the ideal range for babies. That range is between 65 and 70 degrees Fahrenheit - the sort of temperature at which you would be comfortable sitting around in your nightdress.
• Never wrap your baby up in too many layers. Babies at this age cannot regulate their temperature as well as we can. If they are cold, they will usually wake and let you know it - if they are too hot, their bodies can overheat.
• A few babies have apnoea attacks - episodes where they stop breathing for a few seconds or more. If your baby has had such an episode, you should see your doctor as soon as possible. He or she will arrange for your baby to be referred or admitted to hospital for investigation. The consultant may suggest that your baby needs to wear an apnoea alarm, which sends out a signal whenever it does not detect breathing for a certain period. Although it can be very distressing at first - with endless false alarms - it is also very reassuring.