The incidence of sudden infant death syndrome or cot death has decreased by 60 to 70% in the last 10 years. The largest decrease has been following the Back to sleep campaign in 1991. The epidemiology of cot death now emphasises its association with poverty and smoking in the home. The compassionate reception of the 'cot death' baby and his family in the Accident and Emergency department is the first step in enabling families to come to terms with the grief that the death produces. Accident and Emergency staff can facilitate the early grieving process by an understanding of the family's needs and the provision of appropriate information.