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New guidelines to tackle sudden baby deaths

Lyndsay Moss,Health Correspondent,Pa News
Sunday 05 September 2004 19:00 EDT

Families who have suffered the sudden death of a baby should be treated with "sensitivity, discretion and respect", doctors, social workers and police were being told today.

The report - Sudden unexpected death in infancy - comes after the high profile trials of mothers such as Sally Clark and Trupti Patel who were accused of killing their babies but later cleared.

Following a number of cases the Royal College of Pathologists and the Royal College of Paediatrics and Child Health set up a joint working group to consider the investigation of sudden infant deaths.

Many people have complained that parents in such cases are treated like criminals before the real cause of death has been established.

Today the colleges were unveiling their national protocol for how these unexpected deaths should be investigated by all parties involved.

The protocol stresses that all those involved in the investigation should keep an open mind about what has happened and why.

The working group, chaired by Baroness Helena Kennedy QC, said that while the majority of sudden unexpected infant deaths were natural tragedies, a minority were a consequence of ignorance, neglect or abuse.

The experts also highlighted the importance of close collaboration between hospital staff, the pathologist, police, social services, the coroner and others involved in the investigation.

They said that each NHS trust should identify and ensure access to a paediatrician with special responsibility for sudden unexpected infant deaths.

The group said that babies found dead at home should always be taken to the A&E department - not to the mortuary - and resuscitation "should always be initiated unless clearly inappropriate".

They add: "The parents should be allocated a member of staff to care for them and should normally be given the opportunity to hold and spend time with their baby at some point while at the A&E department.

"They should also be offered mementoes, eg. a lock of hair or a photo."

The guidelines set out exactly how the investigation should proceed, with an emphasis on gathering all the available medical and forensic evidence and keeping the parents up to date with what is happening.

This would include explaining the involvement of police and coroner and the need for a post-mortem examination.

The experts said the police should be informed immediately if there is significant suspicion of abuse or neglect so their investigation was not compromised.

The welfare of other children in the household should also be taken into account.

They stressed the importance of a prompt post-mortem, carried out by "the most appropriate pathologist" - usually a paediatric pathologist, or if their are concerns about abuse or neglect a forensic pathologist as well.

"If the post-mortem examination reveals no sufficient identifiable cause of death, whether or not any concerns have been raised during the post-mortem examination or previously about the possibility of abuse or neglect, the pathologist should categorise the death as 'unexplained pending further investigations' and the coroner should in every case hold an inquest," the protocol states.

Pathologist, paediatricians, coroners and police have been working on the report since November last year.

It follows growing concerns about potential injustices involving parents who have been jailed or had children taken away because of fears of abuse.

In many cases, later medical evidence has revealed that the children died of natural causes.

Mrs Clark's convictions were quashed in January 2003 after evidence showed that her two sons died of an undetected lung infection and a bacterial infection. She had spent more than three years in jail.

Concerns have also been raised about expert witnesses in such cases, including Sir Roy Meadow whose evidence was used in the trials of Mrs Clark and Mrs Patel as well as Angela Cannings, who was also cleared of killing her two sons.

These concerns prompted a widespread review of all cases involving parents accused of murdering their children.

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