Sudden unexpected death in infancy (SUDI), SIDS and fatal sleep accidents

Sudden unexpected death in infancy (SUDI) is when babies under one year die unexpectedly and for no obvious reason. SUDI includes fatal sleep accidents and sudden infant death syndrome (SIDS). All babies are at risk of SUDI. Some have higher risk. You can reduce SUDI risk by making sure your baby sleeps in a safe sleep environment. About sudden unexpected death in infancy (SUDI) When babies under one year die unexpectedly and for no obvious reason, it’s often described as sudden unexpected death in infancy (SUDI). Many of these deaths happen when babies are asleep. When these deaths are investigated, they’re often found to be related to one of the following: Medical conditions: these deaths are caused by underlying health conditions that parents or health professionals weren’t aware of. Fatal sleep accidents: these deaths happen when babies suffocate or get trapped or strangled by things in their sleep environments. Sudden infant death syndrome or SIDS: this is when investigations can’t find a cause of death. SUDI is rare and accounts for around 3 deaths in every 10 000 births in Australia. SUDI including SIDS and fatal sleep accidents: risks All babies are at risk of SUDI including SIDS and fatal sleep accidents. The risk of SUDI including SIDS and fatal sleep accidents increases when babies: are premature or have low birth weight have underlying complex medical needs are exposed to cigarette smoke or vapour before or after they’re born are exposed to stimulants or sedating drugs before or after they’re born. Unsafe sleep environments also increase SUDI risk. Safe sleep environments for babies include sleep surfaces, sleep spaces, sleep positions and sleep locations. Reducing SUDI risk by avoiding unsafe sleep environments You can’t control all SUDI risk factors, but you can reduce the risks associated with unsafe sleep environments. Reducing SUDI and SIDS risk: in pictures Baby airway protection during sleep, travel, play and feeding Safe cots, portacots and mattresses Exposure to second-hand smoke or vapour harms babies, and smoking during pregnancy and after birth increases SUDI risk. The link between SUDI and smoking is strong even when parents smoke away from their babies. If you want to quit smoking or vaping and you’re finding it hard, call Quitline on 137 848. You could also speak to your GP or child and family health nurse. Effects of SUDI including SIDS and fatal sleep accidents The sudden or unexpected death of a baby is one of the most difficult and devastating experiences that parents will ever face. They often feel anger, guilt, frustration and, above all, grief. Parents often go over every moment in the last few hours or days of their baby’s life, searching for clues. They might wonder whether their baby might still be alive if they’d done things differently. They might feel guilty they didn’t check on their baby one last time before going to sleep themselves or that they didn’t wake their baby for a midnight feed. When a baby dies from SUDI including SIDS and fatal sleep accidents, it can affect not only parents, but also brothers, sisters, grandparents, family members and friends. If you need support, call the Red Nose Grief Support and Loss Line on 1300 308 307, 7 days, 24 hours. You can also talk to your GP, who can refer you for bereavement counselling. This article has been reviewed for quality and currency by qualified experts, including maternal and child health nurses, MCH Line, Department of Health, Victoria. Scientific Advisory Board review was provided by Dr Bronwyn Gould. Blair, P.S., Byard, R.W., & Fleming, P.J. (2012). Sudden unexpected death in infancy (SUDI): Suggested classification and applications to facilitate research activity. Forensic Science, Medicine, and Pathology, 8(3), 312-315. https://doi.org/10.1007/s12024-011-9294-x. Duncan, J.R., & Byard, R.W. (Eds) (2018). SIDS Sudden infant and early childhood death: The past, the present and the future. University of Adelaide Press. Federico, M.J., Baker, C.D., Deboer, E.M., Kupfer, O., Martiniano, S.L., Stillwell, P., Hawkins, S., & Liptzin, D. (2021). Respiratory tract and mediastinum. In W.W. Hay, M.J. Levin, R.R. Deterding & M.J. Abzug (Eds), Current diagnosis and treatment: Pediatrics (25th edn, Chapter 19). McGraw-Hill. Fleming, P., Bacon, C., Blair, P., & Berry, P.J. (Eds) (2000). Sudden unexpected deaths in infancy: The CESDI SUDI studies 1993–1996. The Stationery Office. Krous, H.F., Beckwith, B.J., Byard, R.W., Rognum, T.O., Bajanowski, T., Corey, T., Cutz, E., Hanzlick, R., Keens, T.G., & Mitchell, E.A. (2004). Sudden infant death syndrome and unclassified sudden infant deaths: A definitional and diagnostic approach. Pediatrics, 114, 234-238. https://doi.org/10.1542/peds.114.1.234. Mitchell, E.A., Freemantle, J., Young, J., & Byard, R.W. (2012). Scientific consensus forum to review the evidence underpinning the recommendations of the Australian SIDS and Kids Safe Sleeping Health Promotion Programme – October 2010. Journal of Paediatric Child Health, 48(8), 626-633. https://doi.org/10.1111/j.1440-1754.2011.02215.x. Moon, R.Y. (2016). SIDS and other sleep-related infant deaths: Evidence base for 2016 updated recommendations for safe infant sleeping environment. Pediatrics, 138(5), Article e20162940. https://doi.org/10.1542/peds.2016-2940. Ostfeld, B.M., Esposito, L., Perl, H., & Hegyi, T. (2010). Concurrent risks in sudden infant death syndrome. Pediatrics, 125(3), 447-453. https://doi.org/10.1542/peds.2009-0038. ACCC Product Safety – Best practice guide for the design of safe infant sleeping environments