GUIDANCE which could lead to more organ donation when babies younger than two months die was published today.

The Royal College of Paediatrics and Child Health (RCPCH) revised the criteria on when to diagnose death. Previously, a very young baby’s heart had to stop beating before death could diagnosed, but now theyan infant can be considered dead if they have no brain function.

The previous criteria stated that it was ‘rarely possible’ to confidently diagnose death by looking at brain activity in a comatose and unresponsive child aged between 37 weeks gestation and two months old.

The updated guidance recommends that the same examination as that used for older children and adults is appropriate. This means the patient should be ‘completely unresponsive’ for at least 24 hours, unable to breathe for themselves and with no response to pain or any basic brain reflex.

Professor Neil McIntosh, chairman of the working group which developed the guidance, said organ donation was not a consideration in why the guidelines were changed: and it was based on observation of children who had lost brain activity. None of them recovered and heart beats eventually stopped without recovery of consciousness or of the ability to breathe. “Continuation of artificial ventilation can no longer be justified as being in the best interests of the child,” he said.

Prior to this guidance, it has been difficult for doctors in the UK to help parents who request that organ donation be considered after the death of their baby before the age of two months. Instead, doctors had to wait until after the child’s heart had stopped. This usually makes donation of any organs, other than heart valves and corneas impossible because organs deteriorate when their blood supply is cut off.

Professor McIntosh said: “It is the case that if this guidance is widely adopted, UK doctors will be able to diagnose death in babies under two months without waiting for the heart to stop and this will increase the chance that organs could be saved for donation. This would usually be considered at the request of the parents and always requires close consultation with them.”.