HC Deb 06 November 1991 vol 198 cc177-9W
Mr. Austin Mitchell

To ask the Secretary of State for Health if he will take steps to facilitate the development of an agreed autopsy protocol for the cot death.

Mrs. Virginia Bottomley

The formulation and adoption of an autopsy protocol for cot death will be for health authorities to determine as part of their involvement in the confidential inquiry into stillbirths and deaths in infancy.

Mr. Austin Mitchell

To ask the Secretary of State for Health what was the recommendation to mothers on whether to lie babies down to sleep on back, front or side in the "Pregnancy Book" issued to all mothers(a) in the version issued in 1990, (b) as revised in 1991, (c) as reprinted in 1991 and (d) as intended now; and how many copies of it were printed for distribution.

Mrs. Virginia Bottomley

[holding answer 5 November 1991]: Advice to pregnant women and mothers contained in the Health Education Authority's "Pregnancy Book" and "Birth To Five" on the recommended sleeping position of babies has been changed once in 1990. Prior to that, the advice was that for the first two months or so babies should sleep on their fronts. This was in accordance with the then commonly held clinical view that not to do so could increase the risk of inhalation of vomit, especially in those babies who were vulnerable or sick.

At the time the text of these books was revised in 1990, the advice was changed to reflect the evidence that was then emerging that the prone sleeping position might have been a risk factor in cot death. On the basis of the evidence at that time, no one type of sleeping position for babies could be recommended. In versions of the booklets reprinted earlier in 1991 this advice continued to be current, although the opportunity was taken to remove photographs of babies lying on their fronts.

Following the chief medical officer's advice last week that babies should no longer be laid down to sleep on their fronts except on medical advice, the authority has taken immediate steps to notify health education units and prevent them from distributing further copies of both books. Urgent steps are being taken to revise the advice in the booklets.

Altogether, approximately half a million copies each of the "Pregnancy Book" and "Birth to Five" are issued to first-time pregnant women and parents each year.

Mr. Austin Mitchell

To ask the Secretary of State for Health (1) what is Government policy on the training of health care workers to deal with cot death;

(2) what steps he is taking to inform health care professionals, doctors, midwives, and maternity homes of how to advise mothers on avoiding cot deaths;

(3) what television advertising his Department intends or has carried out on cot deaths;

(4) how he intends to communicate his advice that young babies should be laid on their backs to (a) health care professionals, (b) the public generally and (c) mothers.

Mrs. Virginia Bottomley

[holding answer 5 November 1991]: Although the underlying causes remain unexplained, as the advice issued by the chief medical officer last week made clear, it is possible to reduce the risk of cot death. Sleeping position is only one factor associated with cot death. Other known risks to be avoided are cigarette smoking, overheating a baby and not acting promptly by seeking professional advice when a baby appears unwell.

Whilst non-breast feeding has been identified as a factor in cot deaths in New Zealand, it has not been identified as a risk factor in the United Kingdom. The Department's advice on the known benefits of breastfeeding remains unchanged.

The chief medical officer's press announcement last week and the media coverage following that, has alerted the public to the new advice relating to sleeping position. The chief medical officer and chief nursing officer will be writing to doctors and to other health care professionals shortly with more detailed advice to guide them in their advice to parents. We would expect the statutory and professional bodies to incorporate the new advice into their curricula straightaway.

In addition, the text of the two books published by the Health Education Authority and distributed to first-time pregnant women and parents, the "Pregnancy Book" and "Birth To Five", is being amended to reflect the new advice. We are considering urgently whether further steps are needed to ensure that the new advice is available to parents of young babies.

Mr. Austin Mitchell

To ask the Secretary of State for Health which parts of the confidential inquiry into stillbirths and deaths in infancy are relevant to cot death; and who has devised these.

Mrs. Virginia Bottomley

My right hon. Friend the Secretary of State will shortly be setting up a national advisory body to advise on which aspects of stillbirths and deaths in infancy should be examined in the confidential inquiry into stillbirths and deaths in infancy.

Mr. Austin Mitchell

To ask the Secretary of State for Health what percentage of infant deaths are given a proper paediatric post-mortem by someone trained as a paediatric pathologist to recognise cot death.

Mrs. Virginia Bottomley

This information is not held centrally.

Mr. Austin Mitchell

To ask the Secretary of State for Health for what reasons the confidential inquiry into stillbirths and deaths in infancy was established.

Mrs. Virginia Bottomley

This inquiry is being established on a nationwide basis to examine in detail the circumstances of selected stillbirths and deaths in infancy. This is the first such inquiry worldwide. With increased knowledge of the reason why babies die, health care professionals and others will be better able to prevent these tragic events.