![]() ![]() ![]() We strongly believe that this is a regressive step and we do not support this new approach. This approach implies that the infant could still be alive if risk factors had not been present and puts unjustified and unfair blame on the families. In recent years, there has also been a tendency by Canadian coroners to categorize risk factors as causes of death, and to exclude a diagnosis of SIDS whenever a known risk factor is present, referring to those deaths as “unsafe sleep” related deaths. While the term SIDS implies a medical condition not yet understood, using the term “undetermined” means that no manner of death has been excluded. Instead, they are using the term “undetermined”. ![]() Since 2012, coroners in most Canadian provinces have made a unilateral administrative decision to stop using the term SIDS to qualify infant deaths for which a cause cannot be found. Why are some babies who die suddenly, unexpectedly and with no identified cause of death not called SIDS victims When a cause of death is identified during the investigation, the final diagnosis will pertain to that cause (for example, infection, heart malformation, or genetic disease). After receiving the reports of all the investigation, if the coroner or medical examiner still cannot determine the cause of death, a diagnosis of SIDS should be retained. The pathologist performing the autopsy carefully examines all organs and regions of the body, searching for abnormalities that might explain the infant’s death. Therefore, parents often receive a temporary diagnosis of SIDS and are referred to associations and support groups for help until the results of the investigation are available through the final autopsy report. Investigations into the cause of death take time. Research has found that there are risk factors that can increase the chances of SIDS occurring. Usually the babies seem healthy or perhaps just recovering from a cold. We know that these sudden deaths are most likely to happen between the ages of 2 and 4 months, although both older and younger babies also die of SIDS. What do we know about SIDS from research?Ī pattern of recurring features has emerged from the results of many SIDS research studies underway around the world. Therefore, it is not surprising that such defects are missed by most forensic centres in Canada performing autopsies on infants who died suddenly and unexpectedly, since these tests are often not performed in these forensic centres. These defects can only be detected by methods of modern cellular and molecular biology. It should be pointed out that in many cases of sudden unexpected infant deaths, there are no overt anatomical abnormalities, and hence the autopsy is reported as negative, since the defects involve submicroscopic, cellular and molecular mechanisms. If a definite cause of death is found, then that becomes the baby’s official cause of death, and while it remains a sudden and unexpected infant death, it is no longer considered a case of SIDS. A diagnosis of SIDS, however, is reserved for those deaths in which a cause cannot be found. In perhaps 15% to 20% of all infants who have died suddenly, the cause of death may prove to be an unsuspected cardiac malformation or a severe, rapidly developing infection. It is also likely that pinpoint hemorrhages, called petechiae, will show up in the thymus gland and the membranes covering the lungs. A slight excess of fluid may appear in the air spaces of their lungs (although not enough to account for the death). Their respiratory tract may be mildly inflamed. Even very experienced pathologists who perform autopsies on these babies may find no adequate explanation. The autopsies of babies who die of SIDS show no obvious cause of death. ![]()
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