Unexpected Death in Childhood

Peter Sidebotham is a Consultant Senior Lecturer in Child Health at the University of Warwick. His main clinical interests are in child protection, sudden unexpected death in infancy and child development and disability. During seven years in Bristol, Dr Sidebotham helped to build up an internationally-acclaimed clinical and academic service for sudden unexpected deaths in infancy. Since moving to Warwickshire, he has built on this experience to work with colleagues in developing a local service of responding to unexpected childhood deaths. He is a council member with the Foundation for the Study of Infant Deaths and sits on the child protection standing committee of the Royal College of Paediatrics and Child Health. Dr Sidebotham is the director of the Warwick Advanced Course in the Management of Unexpected Childhood Death. He is heading up a research team with ongoing research into chi8ld death review processes. Peter Fleming is Professor of Infant Health and Developmental Physiology at the University of Bristol. His clinical practice is in the fields o newborn intensive care, developmental assessment and investigation and care of children with sleep-related disorders, particularly involving breathing. His research is in the areas of developmental physiology, mother/baby interactions (particularly during sleep) and large-scale studies of factors contribut98ng to sudden death in infants. He also has a particular clinical and research interest in the provision of bereavement care to parents after the death of a baby or child. He is a world leader in research into sudden unexpected death in infancy and has published extensively on this and other topics. He has won numerous awards for his work, including a CBE awarded for services to the understanding and prevention of cot deaths. Professor Fleming is a member of the Royal College of Paediatrics and Child Health, the Neonatal Society, the British Association of Perinatal Medicine, the British Sleep Society and the Paediatric Intensive Care Society.

Foreword vii

Preface ix

A Note on Terminology xiii

List of Contributors xv

Acknowledgements xix

I Understanding Childhood Death 1

1 A Family’s Journey 3
Ann Chalmers

2 Childhood Deaths in Context 10
Peter Sidebotham, Peter Fleming

3 Natural Causes of Unexpected Childhood Deaths 25
Peter Fleming, Peter Sidebotham

4 Sudden Infant Death Syndrome 41
Peter Blair

5 Deaths from Unintentional Injuries 61
Jo Sibert, Peter Sidebotham

6 Fatal Child Maltreatment 75
Peter Sidebotham

II Responding When a Child Dies 95

7 Responding to Unexpected Child Deaths 97
Peter Sidebotham, Peter Fleming

8 Police Investigation in Unexpected Childhood Deaths 132
John Fox

9 The Paediatric Post-Mortem Examination 154
Phil Cox

10 Supporting Families 170
Alison Stewart, Ann Dent

III Learning Lessons 203

11 Reviewing Child Deaths 205
Martin Ward Platt

12 Serious Case Reviews 232
Paul Tudor, Peter Sidebotham

Appendices

1 Emergency Department Flow Chart and Checklist 252

2 History Proforma 256

3 Physical Examination Proforma 259

4 Laboratory Investigations 260

5 Scene Examination Proforma 263

6 Resources for Bereaved Adults 265

7 Resources for Professionals 271

8 Practical Information for Families 273

9 Opportunities to Be with Their Child 279

10 Creating Footprints, Photographs and Mementoes 281

11 A Framework to Guide Visiting 284

12 Child Bereavement Network Belief Statement 290

13 Local Case Discussion Proforma 291

14 Child Death Review Core Dataset 294

15 CDRT Proforma for Analysis 301

16 Tools for Developing a Child Death Review Team 304

References 310

Index 339