EDITOR, - In 1992, at the second international conference on the sudden infant death syndrome in Australia, it was decided to keep the 1969 definition: “the death of an infant or young child, which is unexpected by history and in whom a thorough necropsy examination fails to reveal an adequate cause of death.” Caroline Rambaud and colleagues regard this definition of exclusion as “questionable,”1 but we consider that it is essential until more is known of the causes and mechanisms of sudden death in infancy. Although opinion differs over what constitutes “thorough” necropsy examination and what is an adequate cause of death, Rambaud and colleagues understate the wide international agreement on these issues that has been achieved over the past decade.2

Minor histological abnormalities are frequently seen in victims of the sudden infant death syndrome at necropsy. Less than a fifth of …