About 4,300 US infants die suddenly and unexpectedly each year.
We often refer to these deaths as sudden unexpected infant deaths
(SUID). Although the causes of death in many of these children
can’t be explained, most occur while the infant is sleeping in an
unsafe sleeping environment.
Researchers can’t be sure how often these deaths happen because
of accidental suffocation from soft bedding or overlay (another
person rolling on top of or against the infant while sleeping).
Often, no one sees these deaths, and there are no tests to tell
sudden infant death syndrome (SIDS) apart from suffocation.
To complicate matters, people who investigate SUIDs may report
the cause of death in different ways and may not include enough
information about the circumstances of the event from the death
scene.
Interpreting Infant Death
Law enforcement, first responders, death scene investigators,
medical examiners, coroners, and forensic pathologists all play a
role in carrying out the case investigation.
A thorough case investigation includes
- An examination of the death scene.
- An autopsy (medical examination of the body after death).
- A review of the infant’s medical history.
Most SUIDs are reported as one of three types of infant
deaths.
Types of SUID
- Sudden Infant Death Syndrome (SIDS)
SIDS is defined as the sudden death of an infant less than 1 year
of age that cannot be explained after a thorough investigation is
conducted, including a complete autopsy, the examination of the
death scene, and a review of the clinical history. About 1,500
infants died of SIDS in 2014. SIDS is the leading cause of death in
infants 1 to 12 months old.
- Unknown Cause
The sudden death of an infant less than 1 year of age cannot be
explained because a thorough investigation was not conducted and
cause of death could not be determined.
- Accidental Suffocation and Strangulation in
Bed
Mechanisms that lead to accidental suffocation include:
- Suffocation by soft bedding—for example, when a pillow or
waterbed mattress covers an infant’s nose and mouth.
- Overlay—for example, when another person rolls on top of or
against the infant while sleeping.
- Wedging or entrapment—for example, when an infant is wedged
between two objects such as a mattress and wall, bed frame, or
furniture.
- Strangulation—for example, when an infant’s head and neck
become caught between crib railings.
Even after a thorough investigation, it is hard to tell SIDS
apart from other sleep-related infant deaths such as overlay or
suffocation in soft bedding. While an observed overlay may be
considered an explained infant death, no autopsy tests can tell for
certain that suffocation was the cause of death.
Arrival on the scene
It is important an investigator take some immediate action upon
first arriving on the scene. Unlike most death investigations, the
decedent in an infant death has almost always been moved since
discovery. Therefore, it is essential that the investigator uses
this first opportunity to locate and evaluate the location(s)
within the scene where the infant was reported to have been moved
between placement and discovery. While also noting existing
environmental conditions that may have affected the infant.
Upon arrival an investigator should:
- Identify the lead investigator at the scene and present your
identification
- Identify other essential officials at the scene (e.g., EMS,
emergency department personnel, childcare providers, social/child
protective services).
- Explain your role in the investigation.
- Identify and document the first essential official(s) to the
scene for identification for future follow up.
- Determine if the scene is safe to enter
To establish scene parameters and become familiar with the
environment, the investigator should:
- Locate the first responder and/or lead investigator.
- Determine the location where the infant was discovered dead or
unresponsive.
- Determine the location where the infant was last known
alive.
- Determine the location where the infant was placed.
- Identify visible physical and fragile evidence.
- Document and photograph fragile evidence immediately and
collect, if appropriate.
- Observe the physical living environment.
- Locate and view the decedent, if possible.