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Thursday, February 25, 1999 Published at 01:04 GMT


Cot death error 'costs lives'

Cot deaths kill thousands of children a year

Research into cot death syndrome has been held up for more than 20 years by a scientific error that may have cost hundreds of lives.

Much of the research into sudden infant death syndrome (SIDS) has stemmed from a research paper based on one family who had five children who died from unexplained circumstances.

The deaths turned out to have been caused by the children's mother, who suffered from Munchausen's Syndrome By Proxy.

The condition means people enjoy the attention from nurses and doctors when their children get ill.

This leads them to fake or induce the symptoms to keep the doctors' attention.

Breathing problems

Dr Alfred Steinschneider made his name in the 1970s after studying the case of the Hoyt family who lost five of their children.

The Hoyts, from the USA, contacted the doctor after the death of their first child in the 1960s.

He believed the problem was due to the gaps in their breathing while they were asleep.

All babies suffer periods of apnea while they are sleeping, but Dr Steinschneider believed some suffered longer periods than others.

The Hoyts had four more children after their first son Eric died.

All died despite being monitored by Dr Steinschneider.

At that time, some 10,000 babies in the US and UK were dying of SIDS every year.

No-one knew why.

'Revolutionary' findings

Dr Steinscheider published a paper in the journal Paediatrics in the early 1970s.

His research also suggested SIDS was hereditary.

It caused major interest and spawned around 400 subsequent papers which cited his research as an influence.

Breathing monitors became a multi-million dollar industry within 10 years of his research appearing.

[ image: Juanita Hoyt with one of her five children]
Juanita Hoyt with one of her five children
Professor Marie Valdes-Dapena, a child pathologist, told BBC Two's Horizon programme the paper was "revolutionary".

Dr Steinschneider received a $4.5m grant from the US National Institutes of Health to continue his work.

However, subsequent research failed to back up his theory.

He subtly changed it to adapt to the findings and produced many scientific formulae which Dr J Tyson Tilden, who worked with him, said could not be backed up.

Statisticians visiting the doctor also found holes in the research.

But the articles in Paediatrics kept on being published.

Dr Jerold Lucey, editor-in-chief of the journal, said staff at Paediatrics did not understand the formulae, but published the research anyway because it was a "hot topic" - a decision he now regrets.

UK research

In the UK, Dr David Southall of the North Staffordshire hospital, set up his own experiment to test Dr Steinschneider's theory.

He tested 9,000 children and, in 1982, revealed his findings, which blew Dr Steinschneider's theory out of the water.

But still people continued to support it; one paediatrician said it was like religion.

In the same period, more research began into child abuse.

Dr Linda Norton, a forensic pathologist, had studied Dr Steinschneider's research.

She found it suspicious that the Hoyts' children had all died. at the same time of day and while their mother was looking after them. In hospital they seemed fine.

"There are some who say one infant death is SIDS, two leaves a big question mark and with three you yell murder," she said.

In 1994, Juanita Hoyt confessed to killing her children. She retracted her confession before trial and it turned into a test of Dr Steinschneider's work.

Juanita Hoyt was found guilty. Dr Steinschneider retired in 1997 but his work remains in print.

Doctors believe Dr Steinschneider's research could have have held up other studies into SIDS, such as the theory that lying children on their backs can save lives.

Sudden Death is part of the Horizon series and is being shown on BBC Two at 9.30pm on Thursday 25 February 1999.

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