Covert homicide: when SIDS is not SIDS, reasons for the missed identification

Steven A. Koehler, Karen M. Applegate


The sudden and unexpected death of a healthy infant requires a forensic and legal investigation. If the forensic investigation fails to identify a significant cause for the death, the death is labeled Sudden Infant Death Syndrome (SIDS). Among all the possible causes for the death murder is rarely considered in the differential diagnosis. Studies have reported that as many as 20% of SIDS deaths are in fact homicide. This paper will examine factors within the medicolegal and the law enforcement communities that seriously affect the detection of infant deaths that masquerade as SIDS. In addition, it examines how the preconceived portrayal of motherhood by society and societal pressures impede the detection of mothers that murder their children. Among the 2,500 SIDS deaths annually in the U.S., it is estimated that between 25 to 250 of these infants are killed by their mothers. In order to accurately ascertain the number of infants that are murdered requires a significant shift in the mindset of all those involved in the investigation. This will result in justice for the infant, the future protection of other infants, and provide a more accurate representation of infants that truly die from SIDS.

Conclusion - Therefore, to ensure that the true cause of the sudden and unexpected death of an infant is ascertained, all infant deaths must undergo a complete forensic and police investigation. In addition, this practice will ensure the integrity and accuracy of cases designated as SIDS.


Homicide; SIDS; Death investigation; Forensics

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