Introduction

A seemingly healthy infant dies suddenly and unexpectedly. A parent or someone the parent trusted with their infant was nearby, but the moment of death went unwitnessed. The forensic process ensues, including parent and guardian interviews, a death scene investigation, and autopsy. But another highly consequential process also begins: the process through which the infant's parents contend with their profound loss. As they seek an explanation, and the typically inconclusive results of the forensic process become known, they will experience intense emotions and a crisis of meaning. They will continue to face the complexities of coping with their loss for the rest of their lives. Medical relationships during involvement with sudden infant death syndrome (SIDS) begin and occur in a context of grief.

Medical and investigative interactions occur at the time of death, during the investigations, and as results are shared. Bereavement-related supportive services may be available; they may or may not meet the parents’ needs (a situation which is explored in more detail in Chapter 7). There is rarely a plan or anticipatory guidance provided for the future once the death investigation is concluded. The family's usual medical care providers may not feel qualified to offer their assessment or advice, provided they even become aware of the challenges the family faces. All of these services and interactions will be influenced by the parents’ grief, just as their grief will be influenced by the interactions. We can improve our care in this area with an awareness of the parents’ emotional state and their needs. In the following, we present the state of knowledge about psychological coping following the loss of a young child and the process of grief that is seen.

Important Concepts

Grief is the emotional adaptation to loss and the way it is expressed. Those who interact with parents around the time of unexpected infant death would agree that the emotional state of the parents is extremely raw and intense. First moments in dealing with significant losses are predictably overwhelming but, from the perspective of grief research, the quality of grief in this setting underscores important concepts at the heart of the current theoretical understanding of grief.