Doctors Want SIDS Cases Reviewed by Abuse Experts

The nation’s largest group of pediatricians is recommending for the first time that all suspected cases of sudden infant death syndrome be investigated by a child abuse expert because of growing fears that some such deaths are homicides.

The American Academy of Pediatrics and the government already recommend death-scene investigations and autopsies for SIDS cases.

But it is virtually impossible “to distinguish at autopsy between SIDS and accidental or deliberate asphyxiation with a soft object,” said Dr. Kent Hymel, a member of the academy’s child-abuse committee, which wrote the guidelines.

The guidelines say that unless the autopsy examiner is a child abuse expert, a pre-autopsy exam should be done by a specialist. Although cases of parents killing their babies are rare, thorough investigations would probably reveal that some suspected SIDS cases are killings, Hymel said.

The guidelines were published in the February issue of the journal Pediatrics. They mostly reaffirm the guidelines issued by the 55,000-member academy in 1999.

The changes stem from a few highly publicized cases and a 1997 report from British researchers who documented an alarming number of parents trying to suffocate their babies.

Parents were caught on videotape trying to suffocate 30 out of 39 children hospitalized after unexplained or suspicious accidents at home. The researchers also learned that 11 of the children’s siblings had supposedly died of SIDS; parents later admitted to suffocation in eight cases.

The revision was also prompted by the 1997 book “The Death of Innocents,” about a New York woman whose five children supposedly died of SIDS. She ultimately was convicted of smothering them all.

And a Philadelphia mother pleaded guilty in 1999 to smothering eight children whose deaths initially were classified as SIDS.

“What we really want physicians to understand is that SIDS represents an admission by medical professionals that a thorough and exhaustive search for any other cause of death has occurred,” Hymel said. “What’s frightening is that in some cases, that’s not happening.”

The U.S. SIDS rate fell more than 40% from 1992 to 1998--when there were about 2,800 cases--thanks to a national campaign urging parents to put their children to bed on their backs. SIDS has been linked to babies sleeping on their stomachs. Still, it remains the leading cause of death during the first six months of life.