Frequently asked questions

When a healthy baby or child dies suddenly and unexpectedly, it is natural to have lots of questions. However, in the case of a cot death/SUDI, many of those questions will go unanswered. Parents often tell us that this is one of the most difficult aspects of dealing with their child’s death. If you don’t know what caused your child’s death – how can you be sure it won’t happen again?

Hopefully, you will find some answers to the most frequently asked questions. If, however, you have other questions, please contact us and we will do our best to answer them for you.

What is “Sudden Unexpected Death in Infancy” (SUDI)?

When a previously healthy baby or child dies suddenly and unexpectedly, the term “Sudden Unexpected Death in Infancy” (often abbreviated to SUDI), may be used by the medical professionals to explain the death. In the past the terms “cot death” or “SIDS” may also have been used.

Sudden Infant Death Syndrome (SIDS) was defined in 1969 as “the sudden death of an infant or young child which is unexpected by history and in which a thorough post mortem examination fails to demonstrate an adequate cause for death”. SIDS is very rarely used to describe the cause of death on death certificates in Scotland. Terms such as “Sudden Unexpected Death in Infancy” and “Unascertained” are now much more likely to be used.

How does cot death/SUDI happen?

In the majority of cases an apparently healthy infant is put down to sleep without the slightest suspicion that anything is out of the ordinary, although there are sometimes signs of a slight cold or tummy upset. When next checked the infant is found to be dead. Sometimes the time interval is only minutes and sometimes the baby/child has not even been sleeping. There is increasing evidence to show that there is no sign of any struggle, or distress.

Was anyone to blame?

When a previously healthy baby or child dies suddenly and unexpectedly it is normal to need to know “why” it has happened and whether or not someone was to blame. In most cases, the death is nothing more than a devastating tragedy where no-one was to blame and no-one could have done anything to prevent the death.

In Scotland when a cot death/SUDI occurs it is routinely reported to the Procurator Fiscal – as is the case with any sudden, unexpected death – and the Fiscal will order a Police investigation and a post mortem examination. While this is an inevitable part of our legal system it can be very distressing for the parents and can make them feel as if they are under suspicion.

Equally distressing and bewildering is the lack of an explanation for the death. With no reason and no one else to blame, parents often blame themselves, feeling that they must have done, or failed to do, something which led to the death. It is important to understand that cot death/SUDI is unforeseen and therefore unpreventable. The vast majority of cot death/SUDI babies and children have been lovingly cared for. Occasionally the family doctor may have seen the baby/child shortly before the death because of a minor ailment such as a cold, but found nothing which would have indicated a need for serious concern or have led anyone to anticipate a sudden death.

Sometimes parents worry that their baby/child smothered or choked. While it is possible for an infant to smother accidentally, this is rare. Cot death/SUDI is also not caused by vomiting or choking. Sometimes milk or blood-tinged froth is found around the nose or mouth. This occurs during or soon after death and is not the cause of death.

How common is cot death/SUDI?

Until 1991 around 50 babies and children a year died in Scotland, similar to that of other developed countries. Since then the rate has gradually decreased and is now around 40 babies and children each year – a drop also noted in other parts of the world. Although we cannot be certain of the cause of this decrease it is probable that avoiding placing babies on their fronts to sleep has made a major contribution.

“1 baby/child/child dies every 9 days in Scotland”Sadly, about 40 infants die suddenly and unexpectedly in Scotland each year. A cause of death will be found in around 40% of cases but the rest will remain unexplained. SUDI accounts for more infant deaths between the ages of 1 month and 12 months of age than any other cause.

Can we prevent cot death/SUDI?

Since we do not know why cot death/SUDIs occur, we cannot prevent them. However, research has indicated that the risk may be reduced if the following steps are taken:

Place baby/child to sleep on the back in their own safe sleep space.
Avoid smoking during pregnancy and after birth keep baby/child in a smoke-free room
Avoid overheating baby/child
Keep baby/child’s head uncovered – place baby/child’s feet at the bottom of the cot
Consult a doctor if baby/child seems unwell
It is important to understand that even by following the advice on reducing the risks – cot deaths can still occur. This is NOT a sign that the parents or carers have failed to care for their baby or child properly. Sadly, it is nothing more than a devastating tragedy and no-one is to blame.