Advances in technology have provided a better understanding of certain risk factors involved in sudden, unexplained infant deaths (SUIDs). This understanding has allowed authorities to educate parents and caregivers, resulting in a dramatic decrease of Sudden Infant Death Syndrome (SIDS). An unfortunate side effect of this decrease however, has been an increase in the discovery of fatal child abuse masked as SIDS. "Distinguishing Sudden Infant Death Syndrome From Child Abuse Fatalities," found in the February 2001 issue of Pediatrics, is a very detailed article focusing on the importance of proper diagnosis of SIDS. The American Academy of Pediatrics' Committee on Child Abuse and Neglect utilize this article to make recommendations for the evaluation of SUIDs and provide explanations supporting these recommendations. It is important to note that SIDS is a diagnosis of exclusion. All other possible causes of death must be eliminated before a diagnosis of SIDS can be made. A thorough investigation must be made to accomplish this.
A thorough investigation of the death scene, medical history, and a case review are imperative to determine an accurate cause of death. The differences between SIDS and suffocation are very difficult to discern through an autopsy alone. A thorough investigation of the death scene will help to expose cases of infanticide. The committee estimates that "<1% to 5%" of cases diagnosed as SIDS may actually be cases of infanticide. According to the committee the indications of such cases include: recurrent Apparent Life Threatening Events (ALTEs), age of death older than 6 months, and physical evidence of intentional suffocation or abuse. A recent study in Great Britain revealed that of 39 cases referred for evaluation of recurrent ALTEs 33 were in fact cases of abuse. Thorough investigations also bring public health and product safety issues to light. Such issues often lead...