Murder misdiagnosed as SIDS: a perpetrator's perspective

Child murder misdiagnosed as sudden infant death syndrome (SIDS) is a difficult area to study. We present a perpetrator's descriptions to enrich clinicians' knowledge of possible presenting features of this phenomenon.

Interview material was collected as part of a qualitative study of maternal filicide performed from a naturalistic paradigm in order to access the perpetrators' view of events. The woman participant has been convicted for three child murders and two attempted murders which were initially misdiagnosed as SIDS. Interviews were done in the participant's home with her partner present, while she was on leave from prison. Semi-structured interviews were conducted, recorded, transcribed, and analysed for themes. Specific ethical permission was gained to present this case in isolation and the paper was written in consultation with the woman described.

She described initial intense attachment to her first victim and described killing her because she was unable to bear her apnoea attacks and her fear of losing her. She described difficulty grieving for this child and subsequent failure to attach to her next child or feel for the other victims.

Expressions of intense attachment to an infant and description of intense grief over a death in a way which engages compassion should not deter a paediatrician from considering the possibility of the parent having killed the child.