Babies and cot death researchTwo decades ago, 2,000 babies in the UK died each year suddenly and inexplicably while sleeping in their cots. Today these cases have been reduced by 80% thanks to the research and recommendations developed by Peter Fleming, Professor of Infant Health and Developmental Physiology at Bristol University, and his team. The research has prevented approximately 10,000 deaths in the UK and at least 100,000 worldwide as other countries have adopted the recommendations.

Initial research and life-saving recommendations

In the mid-1980s it was recognised that the number of babies dying from Sudden Infant Death Syndrome (SIDS, commonly referred to as “cot death”) had increased in many countries, but no one knew why. Professor Fleming and his team carried out a survey in the Avon area funded by the Foundation for the Study of Infant Deaths (FSID) to try to discover if there were any discernible risk factors relating to cot death. After analysing the data, he pinpointed three potential risk factors: babies sleeping face down; being covered in too many blankets; and being exposed to parental tobacco smoke. The results were published in full in 1990. Initially, researchers refused to believe that factors as simple as this could have such a profound effect and it wasn’t until completing a follow-up study in 1991 that Fleming felt confident enough to approach the government’s health advisers with his findings.

Following a successful trial in Avon from 1989, and with the backing of TV presenter Anne Diamond – who lost her own child through SIDS – the Government gave its official support to the study and launched the highly successful “Back to Sleep” campaign which instructed parents to place their baby on the back to sleep (and not on the front or side). Within a month, the number of cot deaths had fallen by between 30-40% and after two years by nearly 70% – the equivalent of saving 12 babies a week.

Over half of cot deaths occur whilst co-sleeping

Since then, ongoing research by Professor Fleming and others has led to further recommendations on how to reduce the number of losses due to this distressing syndrome. A four year study from January 2003 to December 2006, funded by FSID, found that more than half of sudden unexplained infant deaths occurred while the infant was sharing a bed or a sofa with a parent (co-sleeping), and that deaths may be related to parents who have been drinking alcohol, or taking drugs or medication which might make them sleepy. Guidelines developed from the research advise parents to never put themselves in a situation where they might fall asleep with a young infant on a sofa. Professor Fleming emphasised that, “The safest place for an infant to sleep is in a cot beside the parental bed in the first six months of life.”

Advice should be followed both day and night

An earlier study led by University of Bristol, also funded by FSID, found that advice on how to reduce the risk of cot death needs to be heeded just as much for an infant’s daytime naps as it is for their night-time sleep. The study also found it significant that 75% of the babies who died in the daytime were sleeping in a room without an adult present. Professor Fleming said: “I think what this shows is that we cannot ignore what has traditionally been done.” Babies should always sleep in the same room as their parents or another adult during the day. “In the past and in other cultures it is unheard of to leave babies on their own, and it is something people in western countries should get back to.”

Developing better approaches to investigation and care

Professor Fleming and his team have worked hard to ensure that they are involved in policy decisions relating to their research, and that includes not only preventing SIDS, but developing better approaches to the investigation and care of families after unexpected childhood deaths. Following a number of high profile miscarriages of justice where parents of babies dying through SIDS were jailed, the Kennedy Committee (of which Fleming was part) put forward recommendations to the Government that mirrored practices developed by Fleming and his team in Avon. The approach has now been implemented nationally as part of the Children Act 2004, and integrated into Department for Children, Schools and Families publications such as ‘Working Together to Safeguard Children’, and training DVDs like ‘Why Jason Died’.

Recognition for excellence and continuing research

As a result of Professor Fleming’s work, he has been named as one of the UK’s pioneers of science in ‘Eureka UK’, a book celebrating 50 years of life-changing research, developments and interventions by academics at universities throughout the UK. The book lists the top 100 world-changing, most inspiring and dramatic breakthroughs in academic research. Professor Fleming said: “Thanks to continued research at the University of Bristol and collaborations with different research groups, the work we do has enabled us to have had a considerable impact in over 30 different countries.”