Forensic Science, Medicine, and Pathology

, Volume 11, Issue 3, pp 345–357 | Cite as

An evidence-based guide to the investigation of sudden unexpected death in infancy

  • Joanna GarstangEmail author
  • Catherine Ellis
  • Peter Sidebotham
Original Article



Many countries now have detailed investigations following sudden unexpected death in infancy (SUDI) but there is no clear evidence as to the most effective way to investigate SUDI. This systematic literature review addresses the following questions: What are the current models of practice for investigating SUDI? What is the evidence to support these investigative models? What are the key factors for effective SUDI investigation?


This was a systematic review of papers from Europe, North America, and Australasia, detailing models of SUDI investigation or the outcomes of SUDI investigations.


The review includes data detailing four different models of investigation: police-led, coroner or medical examiner-led, healthcare-led or joint agency approach models. There were 18 different publications providing evidence of effectiveness of these models. All models, with the exception of police-led models, have the potential to reach best practice standards for SUDI investigation. Key factors identified for effective SUDI investigation include the need for mandatory investigation, strong leadership, integration with coronial services, and for investigations to be provided by specialist professionals.


Detailed SUDI investigation should lead to greater understanding of why infants die and should help prevent future deaths. The challenge is now to ensure that local SUDI investigative practices are as effective as possible.


Sudden unexpected death in infancy Sudden infant death syndrome Death scene investigation Cause of death Evidence-based practice 



This paper is based on an evidence check review of evidence for SUDI investigation commissioned by the Sax Institute of New South Wales on behalf of NSW Kids and Families. The funder stated the questions for the literature review and provided some policy documents relating to Australia. The funder had no further involvement in the study design, data collection, analysis or interpretation of the data or in the decision to submit the paper for publication. The views expressed in this publication are those of the authors and not of the Sax Institute or NSW Kids and Families.

Conflict of interest

This study forms part of JG’s doctoral thesis funded by The National Institute of Health Research (NIHR) as a NIHR Doctoral Fellowship (DRF—2010-03-045). NIHR had no involvement in the study design, data collection, analysis or interpretation of the data or in the decision to submit the paper for publication. The views expressed in this publication are those of the authors and not necessarily those of NIHR. CE, PS, none declared.


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Joanna Garstang
    • 1
    Email author
  • Catherine Ellis
    • 2
  • Peter Sidebotham
    • 1
  1. 1.Division of Mental Health and WellbeingWarwick Medical SchoolCoventryUK
  2. 2.Faculty of Health and Life SciencesCoventry UniversityCoventryUK

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