Consensus prevention of crib death. CBO (Central Guidance Organization for Peer Review)

The sudden and unforeseen death of a child in the first two years, usually happening during a sleeping period, is known as cot death. As cot death is a very tragic and dramatic experience for the family, it is important to reduce its incidence. In the period between 1972 and 1987, the number of cot deaths initially increased, but during the last decade a substantial reduction could be observed. This fluctuation can be connected with the position in which the baby is put to sleep. From 1970 the prone sleeping position was strongly recommended. Since then, the number of cot death cases increased. From 1987, a causal relationship between the prone sleeping position and cot death was suspected. As a result the prone sleeping position was strongly advised against. A reduction of cot death cases was then observed. By now, the role of many other factors in cot death has been perceived. The risk of cot death is increased if these factors act at the same time. Some of these factors that promote cot death come from the child's environment and can be influenced when kept in mind. Apart from the prone or side sleeping position, heat congestion, unsafe bed material and smoking in the presence of the child substantially increase the risk of cot death. The main recommendations of the committee which drew up the Dutch consensus report on prevention of cot death are therefore aimed at avoiding the above mentioned risk factors. Continuation of research is necessary to further reduce the current number of some 50 cases of cot death which happen yearly in the Netherlands.