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New reforms could cut the number of unexplained infant deaths
May 25, 2007Reforms introduced as a result of the Sally Clark case could lead to a halving in the number of cases of unexplained infant deaths and a positive legacy emerging from tragedy, says a feature in this week's BMJ.
Sally Clark was arrested in 1998 for the murder of her two infant sons. She was imprisoned but won her appeal in 2003. She died in March this year. The consequences of the case, says Jonathan Gornall, have been devastating for her family and far reaching for the medical and other professions involved.
Protocols introduced as a direct result of the case will be obligatory by April 2008 " the statutory process allowing this to happen has been astoundingly fast says the writer. Peter Fleming, a professor of infant health in Bristol, who implemented a structured system in Avon which will form the template of what will become nationwide protocol, says:
"(this) reflects huge concern within the professions that professionals and families were being let down by the system because nobody knew quite what was required of them."
The reforms establish a standard routine for a collaborative multi-agency response to every sudden unexpected infant death, detailing what is expected from ambulance crews, A&E staff, child protection co-ordinators, coroners, GPs, midwives, paediatricians, pathologists, police and social workers.
Two key changes are that police should visit the home with a paediatrician and a paediatric pathologist should always carry out the examination.
Professor Fleming believes the protocol will ensure more robust and reliable investigations and it could lead to a substantial reduction in the number of deaths from sudden infant death syndrome. When he and his colleagues introduced structured arrangements in Avon in 1984 the benefits soon became apparent " every one of the major risk factors for cot death was first identified there in the 1980s, he says.
The reforms mean new local boards will have to collate information on all deaths in their regions, which will feed into a national enquiry and that can draw nationally applicable conclusions.
However, the article does raise concerns about whether there will be adequate staffing to carry out these new protocols. Child protection has become something of a "poisoned chalice" for paediatricians and pathologists, says the writer, as they are increasingly the target of complaints. Yet, says Professor Fleming:
"Now at least we will be (protecting children) within a recognised and accepted framework, so in theory we can be criticised only if we have failed to do what we should have done, rather than merely for being there."
BMJ-British Medical Journal
"(this) reflects huge concern within the professions that professionals and families were being let down by the system because nobody knew quite what was required of them."
The reforms establish a standard routine for a collaborative multi-agency response to every sudden unexpected infant death, detailing what is expected from ambulance crews, A&E staff, child protection co-ordinators, coroners, GPs, midwives, paediatricians, pathologists, police and social workers.
Two key changes are that police should visit the home with a paediatrician and a paediatric pathologist should always carry out the examination.
Professor Fleming believes the protocol will ensure more robust and reliable investigations and it could lead to a substantial reduction in the number of deaths from sudden infant death syndrome. When he and his colleagues introduced structured arrangements in Avon in 1984 the benefits soon became apparent " every one of the major risk factors for cot death was first identified there in the 1980s, he says.
The reforms mean new local boards will have to collate information on all deaths in their regions, which will feed into a national enquiry and that can draw nationally applicable conclusions.
However, the article does raise concerns about whether there will be adequate staffing to carry out these new protocols. Child protection has become something of a "poisoned chalice" for paediatricians and pathologists, says the writer, as they are increasingly the target of complaints. Yet, says Professor Fleming:
"Now at least we will be (protecting children) within a recognised and accepted framework, so in theory we can be criticised only if we have failed to do what we should have done, rather than merely for being there."
BMJ-British Medical Journal
Infant Death Current Events and Infant Death News RSSAmerican Dietetic Association Releases Updated Position Paper Promoting and Supporting Breastfeeding
The American Dietetic Association has released an updated position paper on breastfeeding that details health benefits for both infants and mothers and encourages promotion of breastfeeding whenever possible.
Over half of cot deaths occur while co-sleeping
More than half of sudden unexplained infant deaths occur while the infant is sharing a bed or a sofa with a parent (co-sleeping) and may be related to parents drinking alcohol or taking drugs, suggests a study published on bmj.com today.
Studies find few risks to newborn offspring of parents who are childhood cancer survivors
Whether they can have children is one of the major concerns for adult survivors of childhood and adolescent cancer because fertility can be compromised by cancer treatment.
Breast milk should be drunk at the same time of day that it is expressed
The levels of the components in breast milk change every 24 hours in response to the needs of the baby. A new study published in the journal Nutritional Neuroscience shows, for example, how this milk could help newborn babies to sleep.
UNC study: Insecticide-treated bed nets reduce infant deaths in Democratic Republic of Congo
Giving insecticide-treated bed nets to nearly 18,000 mothers at prenatal clinics in the Democratic Republic of Congo prevented an estimated 414 infant deaths from malaria, a study by University of North Carolina at Chapel Hill researchers concludes.
Planned home birth with registered midwife as safe as hospital birth
The risk of infant death following planned home birth attended by a registered midwife does not differ from that of a planned hospital birth.
Magazines for women depict babies in unsafe sleep environments
More than one third of photos in women's magazines depicted babies in unsafe sleep positions, according to a new study in Pediatrics.
Rates of secondhand smoke exposure high among college students
Secondhand smoke (SHS) is not only a nuisance, but a potential health concern for many college students, and administrators should be taking steps to reduce students' exposure, according to a new study by researchers at Wake Forest University School of Medicine.
Was SIDS the cause of infant deaths even 150 years ago?
19th century infant deaths attributed to smothering and overlaying, by either a co-sleeper or bedding, were in all likelihood crib deaths, or Sudden Infant Death Syndrome (SIDS).
Simple drug treatment may prevent nicotine-induced SIDS: Study
A new study has identified a specific class of pharmaceutical drugs that could be effective in treating babies vulnerable to Sudden Infant Death Syndrome (SIDS), because their mothers smoked during pregnancy.
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