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Warren Guntheroth, MD; Philip Spiers, PhD
University of Washington School of Medicine Seattle

JAMA. 1993;270(22):2685.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.

—We appreciate the concerns of Hanzlick et al about the effects of reports such as ours on diagnosing and certifying SIDS as a cause of death. In particular, they are concerned that medical examiners will use sleep position as a criterion for certification of SIDS, which could result in the use of alternate diagnostic categories and a spurious decline in SIDS.

We agree that reports of a decline in SIDS rates attributed to public interventions should include assurances that there were no increases in alternate diagnostic categories for sudden and unexpected infant deaths. In our study of the metropolitan area of Seattle, Wash,¹ we found a substantial decline in SIDS deaths with no increase in aspiration, asphyxiation, or unknown categories.

Neither we nor any of the reports that we cited have suggested that sleep position be a criterion for the diagnosis of SIDS. That suggestion could be . . . [Full Text PDF of this Article]

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