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Death of a child: Sudden unexpected death in infancy SUDI

  • See Also

    Death of a child
    Death of a child: Resources

    Key Points

    1. SUDI is a unique situation which is likely to cause an intense response from parents/carers, families and health care professionals
    2. There are specific procedures that need to be followed in addition to those usually required in the event of the death of a child
    3. All cases of SUDI need to be reported to the coroner

    Background

    Definitions

    Sudden unexpected death in infancy (SUDI)
    The sudden, unexpected death of an infant:

    • less than 12 months of age and
    • where the cause was not immediately apparent at the time of death

    Sudden unexpected death during sleep (SIDS)
    The sudden unexpected death of an infant:

    • less than 12 months of age and
    • with onset of the fatal episode apparently occurring during sleep, that remains unexplained after a thorough investigation including performance of a complete autopsy, review of the circumstances of death and clinical history

    Aims

    • Establish, where possible, the cause of death, and help parents/carers and their families to understand how and why the death might have occurred
    • Provide parents/carers with information about any potential health risks for surviving family members
    • Ensure timely completion of the infant’s medical history
    • Ensure that statutory obligations are met, such as liaising with the coroner and the police

    Procedures

    • Verify death (see Death of a child)
    • Obtain a detailed medical history
      • Take a second health practitioner with you, such as another doctor or a senior nursing colleague
      • It is important to obtain specific key details which you might not ask in other situations. These include, but are not limited to, the following:
              Identification:
        • Infant: name, date of birth, date of death, infant details, sex, ethnicity, address
        • Parents: names, dates of birth, consanguinity
        • Health care providers: doctor taking the history, social worker, other professionals present, GP
        • Other medical information: infant health record book, growth chart, information from other healthcare providers such as ambulance officers
             Events surrounding death:
        • Place and time of death, location of death, time found, people present at the scene, resuscitation details, details of confirmation of death
             Medical history:
        • Family: identification and health details of family and household members, parental relationships, other children, any previous childhood deaths in the family
        • Social: type of housing, family support networks, previous involvement with family services, domestic violence, smoking or use of drugs or alcohol
        • Infant: antenatal, birth and postnatal details
        • Events of the past 24-48 hrs: detailed account of events including feeds, sleep, medications, behaviours
        • Events surrounding death: when last seen alive and by whom, details of sleep environment (bed, heating, co-sleeping)
        • Genetic or metabolic diseases
        • Child protection and wellbeing
      • It can be useful to use a checklist to guide you (eg NSW Policy Directive - Management of SUDI Medical History Checklist)
    • Report to coroner, see Death of a child
    • Metabolic & genetic screening
    • Family support
      • See Death of a child: Parent information
      • Provide parents / carers with information about any potential health risks for surviving family members
      • Consider information for breastfeeding mothers

    Additional Resources

  • Reference List

    1. NSW Policy directive: Management of SUDI, https://www1.health.nsw.gov.au/pds/Pages/doc.aspx?dn=PD2019_035 
    2. NSW Policy directive: Management of SUDI Medical History Checklist https://www1.health.nsw.gov.au/pds/ActivePDSDocuments/PD2019_035.pdf#page=19&zoom=100,72,194*