Media vilification of paediatricians acting in cases of alleged child abuse has resulted in widespread confusion about research data and threatens the systems to protect vulnerable children. How should we move forward?

Everyone can empathise with the grief of parents who have lost a baby and even more so with the nightmare scenario of being wrongly held responsible for the child's death. It is therefore not surprising that the media showed intense interest in three recent cases in which mothers were accused of murdering their babies.1 Nothing in this article should be construed as personal opinion on any individual case, but we are concerned that everything we have learnt over the past 40 years about sudden infant death syndrome and the spectrum of child abuse seems to have been forgotten.

Attacks on paediatricians who give evidence in child protection cases^w1 and journalists' use of phrases like “Meadow's discredited theory of Munchausen syndrome by proxy” have left the public and the health professions anxious and bewildered. In this paper we outline the evolving understanding of the relation between unexplained death in infancy and child abuse, draw lessons from recent events, and offer proposals for the future.