SIDS rates in England and Wales reach a new record low

Data released this week by the Office for National Statistics (ONS) show that rates of unexplained infant deaths[1] in England and Wales have fallen to a new record low. There were 191 unexplained infant deaths in 2015 (0.27 per 1000 live births), compared to 217 in 2014, 252 in 2013, and over 300 in 2004 and 2005.

This continues a really encouraging trend that builds on the early successes of the Back to Sleep campaigns of the 1990s. Part of the success could be due to continued declines in maternal smoking (down to 11.4% in 2014/15), and also to the work of the Lullaby Trust and other organisations in promoting safer sleeping messages.

“The further reduction in SIDS rates for 2015 is extremely positive and demonstrates the effectiveness of following safer sleep advice and the importance of making sure that advice reaches all parents and carers. The Lullaby Trust has been campaigning over the past 25 years to ensure that this happens. Although SIDS rates have decreased significantly over the past decade, 191 babies still died in 2015 and the risk has not gone away. We need to ensure that parents continue to recognise the vital importance of following safer sleep advice. Only by making all families aware of the steps they can take to help protect their babies, can we save more lives and drive the number down.”

Francine Bates, Chief Executive, Lullaby Trust

The safest place for your baby to sleep is on their back in a cot in the same room as you

You can find the safer sleep advice on the Lullaby Trust website:

Lullaby Trust Safer Sleep Advice

[1] The ONS data include those deaths coded as Sudden Infant Death Syndrome (R95) and unascertained (R99)

November 30, 2016November 30, 2016

Launching our new national guidelines for responding to unexpected child deaths

The unexpected death of an infant or child is a huge tragedy for any family, leaving them bewildered and grieving, and cutting across all their joys and hopes for their child. While much progress has been made in our understanding of the causes of such unexpected deaths and how to prevent them, sudden infant death syndrome (SIDS) remains the biggest cause of infant death after the first week of life, with over 200 babies per year dying this way in England and Wales. Whenever a child dies unexpectedly, there is a requirement for the coroner to investigate the death. These investigations can, however, further add to the parents’ distress. It is therefore crucially important that each unexpected child death is thoroughly investigated in a sensitive and supportive manner.

Every week at least four families in England and Wales experience the sudden, unexpected death of their child

Sudden unexpected death in infancy and childhood – Multi-agency guidelines for care and investigation

These new national guidelines have been published by a multi-agency working group convened by The Royal College of Pathologists and The Royal College of Paediatrics and Child Health. They provide guidelines for professionals responding to an unexpected child death which are both sensitive to the needs of grief-stricken parents and seek to help parents understand why their child has died.

The revised guidelines build on previous work published in 2004 and seek to outline best practice for the different professionals involved in responding to an unexpected death and to ensure that the response to such deaths is both sensitive and thorough.

I have been enormously privileged to have been part of the group writing these new guidelines, and also to have been involved in some of the research on which they are based. We have seen huge improvements in the ways police and health professionals respond to such deaths, but there is always more that we can learn. So I hope that the revised guidelines will be a stimulus for improving services across the country.

In my work with bereaved families, I have come across terrible situations where parents have been kept in the dark or made to feel like criminals, but also some great examples of how families have been supported through the days and weeks following their child’s death and how police and health professionals have worked together in a sensitive, thorough, and caring manner. Parents often tell me that what they want, above anything else, is to understand why their baby died, but also their hopes that by investigating their child’s death thoroughly, we can work to prevent other families having to go through a similar experience.

The guidelines are freely available for download from the Royal College of Pathologists. Click here to download the guidelines.

The Lullaby Trust

While so many families continue to face this awful tragedy, we must do everything we can to support those families and to prevent future child deaths. Particularly at this time of year, many parents will be feeling the grief so much more intensely. It has been really encouraging to be involved with the Lullaby Trust who continue to work to support families and professionals as well as supporting research and public health initiatives to further reduce the incidence of SIDS. This week, they are once again holding a fundraising challenge through The Big Give: From 12 midday on Tuesday 29 November to 12 midday on Friday 2 December donations made to us via The Big Give website will be matched pound-for-pound; this means a donation to us could go twice as far absolutely free of charge to you!

August 16, 2016

Good news for parents with young babies

The number of unexplained infant deaths in England has fallen to its lowest ever level with just 212 babies dying of SIDS/unascertained causes in England in 2014 compared to 252 the year before[1].

This continues a steady downward trend in the SIDS death rates since the dramatic falls in the early 1990s. To lose a baby suddenly and unexpectedly is one of the worst possible fears of many parents, so the fact that the numbers are continuing to decline is really positive news.

Preventable Infant Deaths

However, for over 200 families to go through this experience each year is still a real tragedy, particularly as many of these deaths are preventable. The data from the Office for National Statistics show that the risks remain particularly high for young mothers, for those without a stable partner, and for those in manual or routine occupations. These are some of the most vulnerable families in our society.

We know what is needed to prevent most of these deaths. Perhaps the biggest impact on the declining SIDS rates has been the continued decline in the number of women smoking during pregnancy, now (2015-16) running at just over 10%, compared to 15.1% in 2006-7.[2]

Data from our 2003-6 study in SW England showed that 57% of mothers whose babies died in infancy smoked during pregnancy compared to just 14% of the random controls.[3] If we can continue to reduce both smoking during pregnancy and postnatal exposure of infants to parental smoking, we could reduce the rates even further.

Spreading the messages about safe sleeping, and helping parents, particularly those in the most vulnerable groups, to follow those messages will also help.

Little Lullaby

To help these parents, the Lullaby Trust launched Little Lullaby earlier this year – a tremendous resource for young parents. I’d encourage you to have a look and pass the link on to any young parents you know.

Little Lullaby is a social network for young parents providing them with a space where they can learn about safer sleep, while also gaining support from their peers through the ups and downs of pregnancy and parenthood

References

[1] https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/unexplaineddeathsininfancyenglandandwales/2014

[2] http://digital.nhs.uk/article/2021/Website-Search?productid=21116&q=number+of+mothers+smoking+during+pregnancy&sort=Relevance&size=10&page=1&area=both#top

[3] Blair PS, Sidebotham P, Evason-Coombe C, Edmonds M, Heckstall-Smith EM, Fleming P. Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England. BMJ 2009; 339: b3666. doi:10.1136/bmj.b3666

March 18, 2016March 18, 2016

SIDS, restorative justice and big tobacco: why I’m feeling angry

The other day I visited a couple whose baby had recently died suddenly and unexpectedly. This family stood out as unusual in that neither parent smoked. The vast majority of bereaved parents whom I have visited over the past years have been smokers, and it seems clear to me that this is one of the biggest modifiable risk factors for SIDS.

In our South West study of sudden infant death in 2003-6, we found that 59% of mothers of SIDS infants had smoked during pregnancy, compared to just 14% of mothers whose babies had not died, equating to a 13-fold increase in risk[1].

And this makes me angry.

Not at the mothers or fathers who expose their babies to such risks, but at the callous greed and indifference of those who continue to produce and market the cigarettes that are killing these babies.

Over the past few months, Lois and I have had the privilege of visiting a local family assessment unit as lay chaplains. The families placed here for assessment come from a range of backgrounds, but all have been treated harshly by life, and the odds seem stacked against them and their babies. Every Saturday night many of these parents come to the chapel with their babies for a bit of space: away from the constant scrutiny and surveillance. Here in this sacred space they can be themselves. We have a laugh together, share some of Lois’ home baking, and join in a simple liturgy of reflection. Many of them ask us to pray a simple prayer of blessing over their baby: they, like all parents, long for their babies to have a better life.

After our time together, almost without exception, these parents congregate outside the chapel, with their babies, in the outdoor smoking shelter. We sometimes stop and chat a bit longer before heading off. And I feel angry. There in that shelter, these parents are slowly poisoning themselves and their babies.

But the parents themselves are victims: victims of the aggressive marketing of the cigarette companies that got them addicted in the first place; victims of a society that alienates and marginalises them; victims of their background and culture that leaves them feeling powerless to change, so that often the only solace they can find is in that little fix of nicotine and tobacco.

And meanwhile, the tobacco companies continue to produce their poison.

In 2012, 5,800,000,000,000 cigarettes were smoked globally.[2]

The WHO estimates that one person dies from tobacco every 6 seconds; 10% of these as a result of exposure to second-hand tobacco smoke.

Meanwhile, the tobacco giants continue to rake in their profits. Jonathan Gornall, writing in the BMJ, cited operating profits of 9.2 billion pounds for Philip Morris International, and £6.1 billion for British American Tobacco.

When I sit down with a parent whose baby has recently died and they ask me that deep, deep question, ‘Why?’ I am sometimes tempted to cry out in pain, ‘Because of the greed and indifference of the chief executives, the board members and the shareholders of the big tobacco companies who have made you and your baby victims! Don’t ask me why your baby died, go and ask them.’

But surely those people, too, must have a heart, somewhere, that beats?

Is it too much to hope that somehow those hearts could be changed?

In his book The Book of Forgiving, Archbishop Desmond Tutu, with his daughter, Mpho, reflect on their painful experiences through their lives in South Africa, and particularly the Archbishop’s involvement in the Truth and Reconciliation commission. Back in the 1980s it seemed impossible to hope that the perpetrators of apartheid and the unjust systems of that country could ever change. And yet, they have found that through the hard, long road of restorative justice, people have changed; truth has come to light; and reconciliation has occurred.

Do I dare to dream of the possibility that just one of these CEOs, or a board member of one of the tobacco companies could one day accompany me as I visit a bereaved family; that they, too, could hear their story; and maybe, just maybe, a glimmer of compassion could be awakened in their heart?

[1] Blair, P. S., et al. (2009). “Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England.” BMJ 339: b3666.

[2] Gornall, J. (2015) Slaying the Dragon: how the tobacco industry refuses to die. BMJ 2015;350:h2052

March 13, 2016May 31, 2016

Safer Sleep Week

Safer Sleep Week, from 14-20 March, is The Lullaby Trust’s national awareness campaign aiming to raise awareness of the importance of safer sleep and how to reduce the chance of Sudden Infant Death Syndrome (SIDS).

In the early 1990s the UK, along with many other countries, saw a dramatic reduction in the number of babies dying as SIDS. In the 1980s over 1,000 babies in England and Wales died suddenly and unexpectedly each year. Following the Back to Sleep and other campaigns, this figure dropped by 2/3, and has continued to fall since. Nevertheless, every year over 200 families lose a baby in this way.

SIDS Incidence, England & Wales, 1985-2011

Over the past 15 years I have met and spent time with lots of families whose babies have died suddenly and unexpectedly. Every single one is heart-breaking: to sit with parents whose baby has just died, to feel their anguish, and to hold their big questions, knowing that there are no easy answers, and nothing I can do to take away the pain.

And yet, perhaps the most heart-breaking thing of all is that so many of these deaths could be prevented. We may not know the causes of SIDS, but we do know very clearly how to prevent it.

The messages are really very simple:

So please, share this blog, get the messages out, and maybe you might help to save a baby’s life.

You can get more information, support and resources on the Lullaby Trust website: http://www.lullabytrust.org.uk/LThome