Checklist May Help You Identify If Your Baby Has SIDS Risk

From the WebMD Archives

Feb. 29, 2000 (Tuscaloosa, Ala.) -- A health assessment questionnaire known as 'Baby Check' might help identify seriously ill babies at risk of sudden death, particularly those who are at high risk, according to a study on sudden infant death syndrome (SIDS) in the February issue of the British medical journal Archives of Disease in Childhood.

SIDS is a term used to describe the sudden death by unknown cause of an apparently healthy infant during the first year of life.

"This paper gives clear evidence that Baby Check could be a useful tool to empower parents to make informative decisions regarding their child's health," says lead researcher Peter S. Blair, of the Royal Hospital for Children in Bristol, England.

Kevin Winn, a leading SIDS expert not affiliated with the study, tells WebMD that the study is important because it shows that "these babies are different at birth, are different after hospital discharge, and are different from normal babies in the 24 hours prior to their deaths. Those differences show up in Baby Check scores."

"The results are striking," continues Winn, a pathologist at Emory University School of Medicine and a member of the governing board of the American SIDS Institute. "We can't look at any one, two, or even three of these signs or symptoms for a definitive diagnosis, but parents and trained health care providers can use this knowledge to determine which babies might be most at risk."

The journal article describes a large scientific investigation designed to compare SIDS babies -- as well as other infants whose deaths were explained but unexpected -- with a large number of infants who did not die. The object of the study was to determine if recognizing specific signs or symptoms might have led to earlier recognition of the infants' illnesses.

The study included all sudden, unexpected deaths of infants ages 7 to 364 days during the three-year study period. There were 456 unexpected infant deaths, of which 363 were classified as SIDS.

Trained interviewers visited bereaved families within days of their baby's death and came back within two weeks to complete a detailed questionnaire -- a modified form of the Baby Check. For each of these cases, researchers also questioned the parents or caregivers of four other infants of about the same age who did not die.

The Baby Check is based on seven symptoms and 12 signs, each of which receives a score.

"We discovered that three of the 19 signs and symptoms occurred in a significantly greater proportion of infants who died of SIDS than in the living babies studied as a control group," explains Blair. "Those signs or symptoms included [infants] being drowsy most of the time when awake, infants wheezing, and infants taking less than half the normal amount of fluids in the last 24 hours before their deaths."

Both Blair and Winn agree that, by themselves, these symptoms are not sufficient to make a diagnosis of illness. "Although these symptoms are statistically significant in the British study, they are not 'house burning down' warning symptoms," says Winn. "The infants didn't have an obvious illness, but they are worthy of attention."

Blair says that if parents note these or the other symptoms in the Baby Check survey, they should add up the scores. If the scores meet the criteria listed in the Baby Check instructions, he encourages parents to contact their health care provider.

"The Baby Check score, as a means of quantifying acute illness, can be used by parents to help them decide whether to seek medical attention," explains Blair. "It can be used by health professionals as a tool to discriminate more reliably between those babies who should be assessed in hospital and those who need not be."

Another sign revealed by the study was that SIDS babies were more than five times more likely than babies who did not die to have had a "life-threatening event," as defined by their parents.

"These events are usually associated with a change in skin color, a type of pallor or bluish discoloration of the skin so the baby looks blue and appears not to be breathing, or the baby look[s] pale and appear[s] not be breathing," Winn says. "Whether or not these events are [actually] 'life threatening' is often a matter of semantics, but for the purposes of this study, this type of event was defined as life threatening."

While experiencing such an event by itself does not necessarily predict SIDS -- it happens to healthy babies also -- Winn still says parents "ought to at least seek advice from their health care provider" if their baby experiences such an event.

Copies of the Baby Check scoring system can be obtained via the following address or telephone number:
Baby Check, P.O. Box 324, Wroxham, Norwich NR12 8EQ. Phone 01603 784400.

Vital Information:

  • A new study shows that a simple, 19-question scored checklist may be able to determine which babies are at risk of sudden death.
  • The Baby Check checklist is based on many symptoms and signs that may not be significant individually, but which taken together may signify a risk of death.
  • Questions on the checklist include:
    In the last 24 hours:
    Has the baby vomited at least half the feed after each of the last three feeds?
    Has the baby had any bile-stained (green) vomiting?
    Has the baby taken fewer fluids than usual in the last 24 hours?
    Has the baby passed less urine than usual?
    Has the baby been drowsy (less alert than usual) when awake?
    Has the baby had an unusual cry (sounds unusual to mother)?
  • The complete checklist may help parents and health care professionals determine when a baby needs serious medical attention.