These deaths must be prevented without victimising parents

EDITOR—Green's article is obviously intended to stir up the cot death establishment.11 When cot death was introduced as a registerable cause of death, largely under the influence of forensic pathologists Bernard Knight of Cardiff and Francis Camps of London, some of us working in paediatric pathology were not in favour of this as we knew that it had many different causes.

We have known from the outset that a proportion of the deaths were technically filicide. In the early 1980s, when we publicly gave the figure of 10%, our findings were fiercely contested, but they were confirmed recently.2 The recent studies by Meadows and Southall et al showing parents deliberately and calculatingly harming their infants apply to only a small proportion of the group of cot deaths that could be classified as infanticide.3 4 In our experience of hundreds of confidential inquiries into sudden unexpected deaths the most usual scenario for filicide is for the baby to have been suffocated by an exhausted parent(usually the mother) while trying to quieten his or her crying. These parents usually barely knew what they were doing and did not intend or want to kill their child.

We need to prevent these deaths, not victimise the parents.

Green's advice to “think dirty” needs to be considered against our experience with the care of next infant (CONI) programme. This programme,funded by the Foundation for the Study of Infant Deaths, provides support for families with children born after a cot …