SIDS and Accidental Asphyxia in Infancy. Forensic Diagnosis

Sudden infant death syndrome (SIDS) is defined as unexpected death of an infant in the first year of life that remains unexplained and etiologically undetermined after a thorough examination, including performance of a complete autopsy and review of the circumstances of death and the clinical history. The lack of underlying etiological cause for SIDS actually makes it a diagnosis of exclusion in most of the cases. Another diagnosis of exclusion in forensic practice is accidental asphyxia in infancy. Based on circumstances of the fatal outcome for an infant, the gross findings and additional examinations, at least an attempt of differentiation between the two causes of death should be performed in the interest of objectivity. We present three cases of accidental suffocation, all of them admitted in the Department of forensic medicine as unclear cases. In all of the cases the initial considerations were between SIDS and accidental suffocation. For both SIDS and accidental suffocation the non compliance with safe sleep position and environment is crucial. To prevent such cases if preventable, especially accidental asphyxiations, it is of major importance the parents to be adequately instructed.