Colleagues of Professor Sir Roy Meadow, the paediatrician whose testimony in a series of cot death cases is being scrutinised by the Attorney General, are rallying to his defence this weekend.

Sir Roy's reputation remains damaged following the acquittal of Angela Cannings by the Appeal Court last week, and the acquittals of Sally Clark and Trupti Patel whose convictions he helped to secure. Mrs Cannings, who lost three children to cot death, was convicted of murdering them partly on the evidence given by Sir Roy. But in quashing her conviction, the Appeal Court judges said his evidence on the chances of more than one cot death occurring in the same family was "wholly erroneous".

But now colleagues of Sir Roy have come to his defence - and they argue that securing a conviction against the parents involved in such cases would now be harder.

The Foundation for the Study of Infant Deaths said one in 16 cot deaths gave ground for suspicion, which amounted to 22 of the 366 children who died of the syndrome last year.

George Haycock, professor of paediatrics at Guy's Hospital, London, said: "Whoever brings these prosecutions will be more hesitant than they have been in the past."

Professor Haycock said this could be positive if all cases of unexpected infant deaths were subject to careful, thorough investigation. A working party chaired by Baroness Helena Kennedy QC, including the royal medical colleges, the police, coroners and social services, is drawing up guidelines for professionals to follow in the event of a cot death, to be issued next year.

In a letter to The Daily Telegraph published yesterday, Professor Alan Craft, president of the Royal College of Paediatrics and Child Health, wrote: "If anyone doubts the importance of child-protection work, they need look no further than the tragic case of Victoria Climbié."

In support of Sir Roy's work, Professor Craft also wrote: "Roy Meadow recognised that parents can harm their children. His work has done an enormous amount to protect children."

Harvey Marcovitch, former consultant paediatrician and spokesman for the Royal College of Paediatrics, paid tribute to Sir Roy's work in uncovering the way in which parents can harm children. "There is a great public disinclination to believe this. But the criminal courts are not the place to find out why a death occurred."

Dr Marcovitch said Sir Roy was keen to answer critics but he had been advised to keep silent by his defence because he was under investigation by the General Medical Council.

Professor Peter Fleming of the Institute of Child Health, Bristol, on whose work Sir Roy based his statistical evidence said: "There are instances where parents harm their children and we must not lose sight of that. It is a nightmare trying to balance between protecting innocent parents and protecting the children."

Rioch Edwards Brown, who runs a campaign on behalf of parents wrongly accused of child abuse, said: "We need a protocol for doctors to follow so that these children, whether alive or dead, are seen within 24 hours to help determine the difference between abuse and accident."

Cot deaths: the medical debate

The number of cot deaths has fallen by 70 per cent since the 1990s, thanks to the "back to sleep" campaign which encouraged parents to put their babies down on their backs to sleep. However, there are still up to 350 deaths a year, most in babies under six months.

According to George Haycock, professor of paediatrics at Guy's Hospital, "perhaps 1 per cent" of cot deaths are due to rare metabolic disorders of the sort cited in the Angela Cannings case.

That leaves 99 per cent that cannot be shown to be caused by these disorders, though there may be inborn errors of metabolism that have not yet been found.

The majority of cot deaths are likely to be due togenetic and environmental factors. "The fact that we don't know the cause doesn't mean there isn't one," Professor Haycock said. "Everyone knows that babies die at the hands of their parents by accident or in a fit of exhausted rage. But the evidence available puts it at less than 10 per cent,"

One source of that evidence is research by Professor Peter Fleming of the Institute of Child Health, in Bristol, North Somerset. He said that in 6-7 per cent of cot deaths, abuse is the main contributing factor, and in a further 4 per cent it may be a contributory factor. "That means 90 per cent of cot deaths are due to natural causes," he said.

Professor Fleming said that in Avon professionals had followed clear rules in response to a cot death, taking a detailed history from the parents and examining where the child died.

"This is not about police going in with sirens on. It is about supporting the parents to find out what happened.

"If that process had been followed in the recent cases it is my view that they probably wouldn't have come to court." JL

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