Table 2 Mentions of SIDS with illustrative quotations, classified by major themes, selected UK newspapers, and nursing journals, 1985–1992

Divided opinion among professionals and confusion of parents

"Professor John Emery...has written to the Lancet questioning the evidence for the supposition that the position the baby sleeps in is an important factor" [49]

"Dr Peter Fleming, a consultant paediatrician at the Royal Hospital for Sick Children in Bristol and a member of the foundation's scientific advisory board, yesterday strongly criticised Acheson for issuing advice to parents to put babies on their sides" [50]

"The change of advice [about sleeping position] has created anxiety and uncertainty among some parents and professionals" [50]

A mother was quoted "Simply following the latest theory on [SIDS] prevention may not be as simple as it sounds. [With] my first child...I felt moderately secure that I was doing the right thing by carefully placing him [as] advised to do in hospital...Now we learn that there are other views" [50]

Association between prone sleeping position and SIDS risk

"Low rate of SIDS in Hong Kong may be related to the Chinese practice of placing the sleeping infants on their backs" [17]

"Recent reports in the BMJ [51,52] suggest that the position in which a baby sleeps may have a lot to do with why healthy babies unexpectedly die in their cots" [18]

"Most of those who died were sleeping in the prone position" [19]

"There are grounds for thinking that the prone position may contribute to cot death" [53]

"Reflecting recent concerns that putting babes on their stomachs may contribute to cot deaths" [54]

Uncertainty within the nursing profession

"I think this latest advice is an anathema to many health professionals, and we have had some quite irate phone calls from some of our members" [24]

"...recently there has been much discussion about whether babies placed in the prone position rather than supine are more at risk of cot death. Although a few studies found that more babies were found lying in a prone position and this could be a contributory factor, this has not been statistically proven" [21]

"There are conflicting opinions. Unless there is an obvious reason for the prone position no 'right' position emerges" [23]

"A non-prone position does not guarantee not to have SIDS. However in response to these findings [review of literature from 1988] the Department of Health has published and widely circulated a leaflet advocating a non-prone position. The effect of this campaign has yet to be seen" [55]

"I have picked up some information about the new position casually from the media but since the birth neither the GP, midwife or health visitor have raised the subject voluntarily...In fact, I felt that maybe [the health visitor] wasn't so convinced herself" [56]

"...many nurses trained since the 1960s are finding the change hard" and the Alison Stewart, the Avon infant mortality study coordinator states "the government have given health professionals little background evidence to reinforce the programme, and until they become convinced that the position is safe we are dramatically reducing the effectiveness of our message" [56]