Examining recurrent SUDI in families


An incident of sudden unexpected death in infancy (SUDI) is a tragedy. More than one incident in a family raises questions. A report defines the rate of recurrent SUDI and the causes of death in those cases.

Sudden unexpected death in infancy (SUDI) is a tragic event for families. Some families experience more than 1 incident of SUDI. A report in Archives of Disease in Children sought to define the rate of SUDI that occurs after a previous incident of SUDI.1

Researchers used the UK’s Care of Next Infant (CONI) program. The program was designed to give additional care to families who had experienced SUDI following the birth of successive children. All of the infants had been registered in CONI between January 2000 and December 2015. A totally of 6608 live-born infants were registered.

Among the 6608 registered infants, there were 29 deaths. Twenty-six families had 2 deaths and 3 families had 3 deaths. After 1 incident of SUDI, the SUDI rate is 3.93 per 1000 live births. Investigators also looked at the cause of death for both first SUDI and later incidents when registered in CONI. Unexplained cause of death was found for 19 first SUDI incidents and 15 CONI incidents. Accidental asphyxia was seen for 2 first incidents and 6 CONI deaths; medical causes were seen for 3 first incidents and 4 CONI deaths. Homicide was the cause for 2 first incidents and 4 CONI deaths. Child protection concerns were found for 10 families.

Researchers concluded that the SUDI rate among siblings is 10 times higher than the current rate of SUDI in the United Kingdom. The results indicate that homicide presenting as recurrent SUDI is uncommon, but the researchers did warn clinicians to not be complacent about it. They also found that many parents continued habits such as smoking and hazardous co-sleeping conditions after the first incident of SUDI. These habits were found to directly lead or contribute to 6 sibling deaths. The researchers stated that SUDI parents frequently need support to improve parenting abilities that can cut the risk of SUDI in future children.


1. Garstang JJ, Campbell MJ, Cohen MC, et al. Recurrent sudden unexpected death in infancy: a case series of sibling deaths. Arch Dis Child. June 11, 2020. Epub ahead of print. doi:10.1136/archdischild-2019-318379

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