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Abstract
The Care of Next Infant (CONI) programme is offered through health services to provide extra support to families with babies born following a cot death. Audit of centrally collected data about families registered with the programme and feedback from parents show that compared with national data, families on CONI have more factors associated with an increased risk of cot death, confirming that a history of cot death identifies a particularly high-risk group. The programme, first offered to parents in 1988, remains attractive and helpful to parents in the 21st century. The CONI programme, including provision of a movement monitor, enables health visitors to deliver a targeted programme of extra care to a vulnerable group of babies.
Key words
Cot death, vulnerable families, targeted health visiting, respiratory movement monitor
Community Practitioner, 2011; 84(1): 25-9.
Declaration of potential competing interests: Charlotte Daman-Willems is a trustee of FSID and chairman of its Information and Support Committee.
Introduction
Sudden unexplained infant death (usually referred to as cot death) is the leading cause of post neonatal mortality. There were 312 cot deaths registered in the UK in 2008 (0.39/1000 live births) (Foundation for the Study of Infant Deaths/FSID, 2010). The death of a child has a lasting impact on parents and certain life events will draw the loss to the fore even years later. One such is the birth and infancy of subsequent children about whom parents are additionally and understandably anxious. A research study (Emery et al, 1985) was funded by FSID to evaluate whether apnoea monitors reduced or prevented deaths in siblings of cot deaths. Monitors or weighing scales were randomly allocated but mortality was not significantly different between the two groups of babies. The results suggested that at least 6000 babies would need to be enrolled to properly evaluate monitors. As this seemed unachievable, FSID developed a protocol to support families using experience gained from the study, which became the Care of Next Infant (CONI) programme.
CONI involves the paediatrician, health visitor, GP and midwife. Each family is enrolled onto the programme by a specially trained local CONI co-ordinator, usually a health visitor. Parents choose from weekly or regular contacts at home with their health visitor, symptom diary, apnoea monitor, weekly weighing and room thermometer....