Rev. 2004

Responding to a Sudden, Unexpected Infant Death: 

The Professional’s Role

Parents and families who experience the sudden, unexpected, and

unexplained death of an infant are faced with an enormous sense of loss,

sorrow, and confusion. Immediately after the baby’s death and in the

weeks and months that follow, parents, other family members, and

caregivers will interact with many health and social service professionals.

Some of these individuals—police, fire, rescue squads, and emergency

medical technicians—respond to the emergency call for help. Others—

emergency room doctors and nurses, medical examiners, pathologists, and

coroners—try to find out why the baby died. Still others—funeral

directors, clergy, public health nurses, and bereavement counselors—are

there to help the parents and other family members get through the sad

and difficult days that follow the death of an infant. It is not surprising

that at times, having to deal with these individuals can be quite

overwhelming. This fact sheet provides a brief overview of the various

professionals involved when a sudden infant death occurs, as well as their

responsibilities and how these professionals can help.

First on the Scene

When a parent or caregiver finds an unresponsive baby, he or she usually

phones “911” for help. Most often, the first responder is a police officer,

firefighter, or other emergency medical services personnel—sometimes

all three. Whoever arrives first will examine the baby and may start

cardiopulmonary resuscitation. They also examine the baby’s

surroundings and take notes that help in determining the cause of death.

Bedding, potentially hazardous objects, medicines, formula, and other

items may be collected. Depending on the community, the infant may be

transported to the nearest hospital emergency department or remain at

home until the medical examiner or coroner arrives. 

National Sudden

Infant Death

Syndrome/

Infant Death

Resource Center
2

At the Hospital

When efforts to revive the infant are unsuccessful,

emergency room staff (usually a doctor or nurse) is

responsible for telling the parents and/or family members

that the baby has died. Because the death is such a

devastating event, nurses and/or special counselors at the

hospital often provide emotional support and guidance. 

Autopsy

In many communities, the law requires an autopsy in

cases of sudden and unexpected death. Although it may

be emotionally difficult for parents, an autopsy may help

answer questions

about what caused the

baby’s death. An

autopsy is very

important when a

sudden infant death

syndrome (SIDS)

death is suspected

because a final

diagnosis cannot be

made without a

thorough postmortem examination.

Some ethnic and religious groups forbid autopsies. In

these situations, the family may wish to talk with their

clergy, spiritual leader, or a mental health counselor.

These individuals may be able to help the parents and

other family members reconcile the need for an autopsy

with their cultural beliefs, values, and practices.

In most cases of sudden, unexpected infant death, the

cause and manner of death are determined by the medical

examiner or coroner for the county, district, or State

where the death occurred. The autopsy is conducted or

supervised by a specialist (pathologist) who reviews the

medical aspects of the death. If possible, parents are

notified of the preliminary autopsy results within 24 to 48

hours of the death. Once the autopsy report is available,

the doctor should explain the results of the autopsy to the

family, often reassuring them that the baby’s death could

not have been predicted.

Death Scene Investigation

Staff from the medical examiner/coroner’s office or law

enforcement agency will collect information about the

location and circumstances at the time of the infant’s

death. The investigator will try to learn as much as

possible about the events leading up to the death—even at

the very moment the death occurred. The investigator will

interview individuals who were caring for the baby. Some

typical questions that are asked include, “What time was

the baby put to bed?” “Had the baby been ill recently?”

“When did the baby fall asleep?” “Were the covers over

the baby’s head?”

Answers to these questions will help investigators find

out what happened when the baby died, hopefully

shedding light on the cause of death. It is very important

to remember that the investigator is not trying to blame

anyone for the baby’s death, but is simply trying to

determine how the baby died. 

The Days Ahead

Sudden, unexpected death—especially the sudden,

unexpected death of an infant—strikes at the heart of

everyone’s sense of order and security. The grief and

Coroner

A coroner is an appointed or elected public official in

a particular community, county, or region. The

coroner is responsible for making inquiries into

certain types of deaths but does not have to be a

physician. The coroner verifies the cause of death

and may employ physicians, pathologists, or forensic

pathologists to perform autopsies. 

Medical Examiner

A medical examiner is the physician responsible for

the investigation and examination of victims whose

deaths are sudden, unexpected, or violent. The

medical examiner is expected to use his or her

medical training and expertise to evaluate the

medical history, circumstances of the death, and

autopsy examination. 

Pathologist

A pathologist is a physician specially trained in

diagnosing disease and determining the cause of

death by laboratory examination of body fluids, cell

samples, and tissues. Usually, the pathologist (or

forensic pathologist) conducts the autopsy. 

Forensic Pathologist

A forensic pathologist examines victims whose

deaths are sudden, unexpected, or violent. The

forensic pathologist is an expert in determining cause

and manner of death.

Sudden Infant Death Syndrome is

the sudden death of an infant

under 1 year of age which remains

unexplained after a thorough case

investigation, including

performance of a complete

autopsy, examination of the death

scene, and review of the clinical

history (Willinger et al., 1991).
3

sorrow felt by the parents, other family members, friends,

and other caregivers are normal responses to the death. It

can take a long time for the family to regain the desire

and energy to move on.

Some communities have responded to these challenges by

developing an outreach program for families whose baby

has died suddenly and unexpectedly. These programs

provide professional case management, counseling,

referral, and support services. In some locales, a

community health nurse, social worker, or trained

community outreach worker visits the family in their

home. In some States, the program works with the

medical examiner or coroner, contacting the family

immediately after the death. Families can contact their

local health department about these types of services in

their community.

During the grieving process, a mental health professional

(psychiatrist, social worker, psychologist, or grief

counselor) can help the parents and family express

feelings that need to be released. These professionals can

answer questions and help parents cope with the changes

in their lives caused by the loss of their child. Some

families may seek the help of their clergy, specially

trained pastoral counselors, or other spiritual guidance.

For More Information,

Please Contact

National SIDS/Infant Death Resource Center (NSIDRC)

2070 Chain Bridge Road 

Suite 450

Vienna, VA 22182

Phone: (866) 866-7437

Phone: (703) 821-8955 (local)

Fax: (703) 821-2098

Email: sids@circlesolutions.com

www.sidscenter.org

Other Resources

American Board of Medicolegal Death Investigators

Room 512

1402 South Grand Boulevard

St. Louis, MO 63104

Phone:(314) 268-5970

Fax: (314) 268-5695 

http://www.slu.edu/organizations/abmdi

Association of SIDS and Infant Mortality Programs

(ASIP)

c/o New York Center for SIDS

School of Social Welfare, Stony Brook University

Stony Brook, NY 11794-8232

Phone: (631) 444-3690

Fax: (631) 444-6475

http://www.ASIP1.org

The Compassionate Friends

PO Box 3696

Oak Brook, IL 60522-3696

Phone: (877) 969-0010

http://www.compassionatefriends.org

First Candle/SIDS Alliance

Suite 210

1314 Bedford Avenue

Baltimore, MD 21208

Phone: (800) 221-7437

www.sidsalliance.org

MISS: Mothers in Sympathy and Support

PO Box 5333

Peoria, AZ 85385-5333

http://www.misschildren.org

National Association of Emergency Medical Technicians

PO Box 1400

Clinton, MS 39060-1400

Phone: (800) 34-NAEMT

http://www.naemt.org/

National Association of Medical Examiners

430 Pryor Street SW

Atlanta, GA 30312

Phone: (404) 730-4781

Fax: (404) 730-4420

http://www.thename.org/

National Funeral Directors Association

13625 Bishop’s Drive

Brookfield, WI 53005

Phone: (800) 228-6332

http://www.nfda.org/
4

This publication was produced by the

National SIDS/Infant Death 

Resource Center (NSIDRC)

2070 Chain Bridge Road

Suite 450

Vienna, VA 22182

Phone: (866) 866-7437, (703) 821-8955

E-mail: sids@circlesolutions.com

www.sidscenter.org

National SIDS & Infant Death Program Support Center

(NSIDPSC)

Suite 210

1314 Bedford Avenue 

Baltimore, MD 21208

Phone: (800) 638-7437

Fax: (410) 415-5093

www.sids-id-psc.org

National Fetal and Infant Mortality Review Program

(NFIMR)

PO Box 96920

Washington, DC 20090-6920

Phone: (202) 863-2587

Fax: (202) 484-3917

www.acog.org/goto/nfimr

SHARE Pregnancy and Infant Loss Support, Inc

National Share Office

St. Joseph Health Center

300 First Capitol Drive

St. Charles, MO 63301-2893

Phone: (800) 821-6819

Fax: (636) 947-7486

Email: share@nationalshareoffice.com

www.nationalshareoffice.com 

References

Association of SIDS and Infant Mortality Programs. (2001). The

Unexpected Death of an Infant or Child: Standards for Services to

Families. Minneapolis, MN: Association of SIDS and Infant Mortality

Programs.

Arnold J, McClain ME, Shaefer SJM. (1997). “Reaching Out to the

Family of a SIDS Baby.” In:Woods, JR and Woods, J.L.E. (Eds), Loss

During Pregnancy or the Newborn Period. Pitman, NJ: Jannetti

Publications, Inc.

Centers for Disease Control and Prevention. “Guidelines for Death

Scene Investigation of Sudden, Unexplained Infant Deaths:

Recommendations of the Interagency Panel on Sudden Infant Death

Syndrome.” Morbidity and Mortality Weekly Report, 1996; 45 

(No. RR-10).

Horchler J. (1994). The SIDS Survival Guide: Information and

Comfort for the Grieving Family and Friends & Professionals Who

Seek to Help Them. Hyattsville, MD: SIDS Educational Services.

National Association of Medical Examiners. “So, You Want to be a

Medical Detective?”

http://www.thename.org/medical_detective.htm.

National Institute of Child Health and Human Development. (June

2001). Targeting Sudden Infant Death Syndrome (SIDS): A Strategic

Plan. Rockville, MD: U.S. Department of Health and Human Services,

National Institutes of Health.

Valdes-Dapena, M. “The Postmortem Examination.” Pediatric Annals,

July 1995; 24(7): 365–372.

Willinger M, James LS, and Catz, C. “Defining the Sudden Infant

Death Syndrome (SIDS): Deliberations of an Expert Panel Convened

by the National Institute of Child Health and Human Development.”

Pediatric Pathology, September–October 1991; 11(5): 677–84.

The NSIDRC is funded under contract to Circle Solutions, Inc., with the Maternal and Child

Health Bureau (MCHB), Health Resources and Services Administration, U.S. Department

of Health and Human Services. This publication is not copyrighted; it may be reproduced

in whole or in part without permission. However, in accordance with accepted publishing

standards, it is requested that proper credit be given to the source(s). The views in this

publication do not necessarily reflect the views of the sponsoring agency.

Health Resources and Services Administration

Maternal and Child Health Bureau

SIDS/Infant Death Program

(301) 443-2115

www.hrsa.gov