Baby Docs: Possible Murder in SIDS Cases

C H I C A G O, Feb. 5, 2001 -- The nation’s largest group of pediatricians isrecommending for the first time that all suspected cases of suddeninfant death syndrome be investigated by a child abuse expertbecause of growing fears that some such deaths are murders.

The American Academy of Pediatrics and the government alreadyrecommend death-scene investigations and autopsies for all SIDScases.

But it is virtually impossible “to distinguish at autopsybetween SIDS and accidental or deliberate asphyxiation with a softobject,” said Dr. Kent Hymel, a member of the academy’schild-abuse committee, which wrote the updated guidelines.

The new guidelines say that unless the autopsy examiner is achild abuse expert, a pre-autopsy exam should be performed by aspecialist.

More Investigations Might Reveal Murder

While cases of parents killing their babies are rare, morethorough investigations would probably reveal that some suspectedSIDS cases are murders, Hymel said.

The updated guidelines were published in the February issue ofthe journal Pediatrics. They mostly reaffirm the guidelines issuedby the 55,000-member academy in 1999.

The changes stem from a few highly publicized cases and a 1997report from British researchers who documented an alarming numberof parents trying to suffocate their babies.

Parents were caught on videotape trying to suffocate 30 out of39 children hospitalized after unexplained or suspicious accidentsat home. The researchers also learned that 11 of the children’ssiblings had supposedly died of SIDS; parents later admitted tosuffocation in eight cases.

“Physicians don’t want to consider these kinds of acts,” Hymelsaid.

The revision was also prompted by the 1997 book The Death ofInnocents, about a New York state woman whose five childrensupposedly died of SIDS. She ultimately was convicted of smotheringthem all.

More recently, a Philadelphia mother pleaded guilty in 1999 tosmothering eight children whose deaths initially were classified asSIDS.

“What we really want physicians to understand is that SIDSrepresents an admission by medical professionals that a thoroughand exhaustive search for any other cause of death has occurred,”Hymel said. “What’s frightening is that in some cases, that’s nothappening.”

The U.S. SIDS rate fell more than 40 percent from 1992 to 1998 — when there were about 2,800 cases — thanks to a national campaignurging parents to put their children to bed on their backs. SIDShas been linked to sleeping on the belly.

SIDS Leading Cause of Death in First 6 Months of Life

Still, SIDS remains the leading cause of death during the firstsix months of life.

The academy’s recommendation has raised objections from membersof the National Society of Medical Examiners, who say that havinganother person examine the body could alter evidence and interferewith the autopsy.

Medical examiners receive training that should adequatelyprepare them to detect child abuse, said Dr. Randy Hanzlick, thesociety’s president and medical examiner for Fulton County, Ga.

Dr. Henry Krous, a leading SIDS specialist and pediatricpathologist at Children’s Hospital of San Diego, said that in someareas of the country, how a body is moved and treated after deathis legally under the medical examiner’s jurisdiction.

Krous served as a consultant for the new guidelines and said hegenerally supports them. But he also said they could unfairlycreate an aura of suspicion over innocent parents already wrackedwith grief.

“I hope there isn’t a general viewing of the public that SIDSis likely murder until proven otherwise,” Krous said. “Theevidence to the contrary is overwhelming.”