Intended for healthcare professionals


Debate on cot death

BMJ 2000; 320 doi: (Published 29 January 2000) Cite this as: BMJ 2000;320:310

These deaths must be prevented without victimising parents

  1. J L Emery, emeritus professor of paediatric pathology, University of Sheffield,
  2. Alison J Waite (, national CONI organiser
  1. Room C1, Stephenson Wing, Sheffield Children's Hospital, University of Sheffield, Sheffield S10 2TH
  2. Friarage Hospital, Northallerton, North Yorkshire DL6 1JG
  3. Child and Family Consultation Centre, London W6 7DQ
  4. Baker and Duncan Family Consultancy, Ashwood Centre,Brookwood, Woking, Surrey GU24 0BL

    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 …

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