SUDDEN AND UNEXPECTED DEATHS IN INFANCY (SUDI) PREVENTION
What is SUDI?
The sudden and unexpected death of a baby is usually referred to by professionals as ‘sudden unexpected death in infancy’ (SUDI). The death of a baby which is unexpected is also sometimes referred to as ‘sudden infant death’.
Some sudden and unexpected deaths can be explained by the post-mortem examination, however deaths that remain unexplained are usually registered as ‘sudden infant death syndrome’ (SIDS). Sometimes other terms such as SUDI or ‘unascertained’ may be used.
Known risk factors that can contribute to SUDI
- Parents who smoke or have consumed alcohol or substances (including prescription medication that may make them drowsy)
- Smoking, alcohol and/or substance misuse in pregnancy
- Babies born before 37 weeks or who have a birth weight less than 2.5kg
- Co-sleeping when known risk factors are present
- Parental mental ill-health and domestic abuse
- Overcrowding, poor housing and social deprivation
- Disruption to normal routines prior to ‘the last sleep’
A key role for professionals is to support parents to apply safer sleeping practice particularly where situational risk or ‘out of routine sleeping’ may be a factor. Key examples are:
- Temporary housing
- Altered sleeping arrangements (holidays, family occasions, staying with relatives, illness, fleeing domestic abuse)
- Planned use of alcohol and prompting arrangements to maintain safer sleep practices
- Deprivation and poverty indicators, overcrowding
- Adverse childhood experiences / impact on key messages being understood
- Late booking and poor antenatal/postnatal engagement
- Evidence of neglect, domestic abuse and parental criminality
The Local Picture
North Yorkshire and York Safeguarding Children Partnerships have seen a sharp increase in the number of babies who have died as a result of unsafe sleep practices. In response to this increase, the North Yorkshire and York (NYY) Child Death Overview Panel (CDOP) have agreed to focus on safer sleep and SUDI Prevention as one of their priorities to raise awareness and training to help prevent SUDI going forward.
The National Picture
Over 300 babies and young children still die every year from SUDI in the United Kingdom. National research coordinated by the Lullaby Trust has established some key modifiable factors associated with an increased risk of SUDI.
In July 2020 the National Child Safeguarding Practice Review Panel published a Thematic Report on SUDI which described the findings from a review into SUDIs in families with known vulnerabilities:
North Yorkshire and York (NYY) Response
- A SUDI Prevention Task and Finish Group has been convened by the NYY CDOP
- An NYY Audit confirmed health providers across NYY are delivering research based safe sleep messages to all parents ante-natally and post natally
- NYY acknowledged that SUDI Prevention needs to be seen in the context of the safeguarding continuum
- NYY identified more work is required across the multiagency partnership to ensure that SUDI Prevention messages reach the most vulnerable families
- The adoption of a proposed ‘Prevent and Protect Model’ across NYY to ensure all relevant agencies/ practitioners have the necessary skills and knowledge to work with families where there is increased risk
What can I do?
- Reinforce key safer sleep messages with all new parents, grandparents and significant others
- Identify families who are most vulnerable and explore risk issues with the family
- Consider does this family need additional support and /or is this a safeguarding concern?
- As the ‘Prevent and Protect Model’ is developed access resources and engage to embed this model in to practice
- The Lullaby Trust raises awareness of sudden infant death syndrome (SIDS), provides expert advice on safer sleep for babies and offers emotional support for bereaved families www.LullabyTrust.co.uk
- Babies Cry, You Can Cope (ICON) programme supports parents and carers manage normal infant crying and to prevent abusive head trauma injuries to babies caused by shaking, also referred to as ‘shaken baby syndrome’ ICON Infant Crying and how to Cope
- Multi-Agency Practice Guidance Pre Birth Assessment Tool