Roy Meadow breaks his silence to tell Margarette Driscoll why 
cot deaths must be treated with suspicion

On November 26, 1999, Sally Clark, a Manchester solicitor, was convicted of murdering her two baby sons and jailed for life. It is one of those difficult, niggly cases that won't go away; doubts have been raised ever since over whether the conviction was safe.

Christopher died in 1996, aged 11 weeks; his eight-week-old brother Harry just over a year later. Both were alone with their mother when they stopped breathing.

Clark has always vehemently protested her innocence and insists that she is the victim of an appalling double tragedy. Her supporters believe the babies died of some undiagnosed illness or genetic flaw and that Clark has been needlessly persecuted over a double cot death.

The crucial point in the trial - according to Clark's husband Stephen, a high-flying corporate lawyer, and her father, a retired senior police officer, who have assembled a formidable campaigning lobby of medical experts and campaigning journalists around them - was the assertion that the chances of a woman like Clark (affluent and non-smoking) suffering a double cot death was one in 73m. Amid a welter of conflicting and disputed medical evidence, here was a clear concept that the jury could easily understand. The trouble was that the figure, in this context, was wrong. 

The statistic was offered to the court by Professor Sir Roy Meadow, former president of the British Paediatric Association and a distinguished scholar in the field of child abuse. It was not his, but taken from a government report into cot death. Nonetheless, since the trial, he has been vilified and his expert testimony called into question. 

Meadow has chosen not to defend himself publicly until now. He concedes that the figure he used in the Clark case was misleading.

It gave the overall chance of a middle-class non-smoker suffering two cot deaths: more appropriate would be to point out that once such a woman suffered one cot death, the chance of a second would be just as great. 

"I did not explain the limited significance and I regret I didn't," he says. "But in court, it was not a defining moment. At that time no one, not even the defence, was arguing that these were cot deaths because both babies had unexplained injuries." 

Though he remains convinced that she is guilty, he is bemused at being fingered as the man who put Sally Clark in jail. "It's terrible," he says. "I have probably more sympathy for her than most of the population. I don't think a custodial sentence is appropriate for people who have problems with their children.

They're not a danger to the community. It's just very, very sad." 

Meadow, 68, has long been a controversial figure. In the 1970 she was the first to observe and give a name to Munchausen syndrome by proxy, where parents draw attention to themselves by harming their children. More recently, his research into unnatural infant death has suggested that "cot death" is sometimes a term used to cover "awkward truths".

He advises casting a particularly sceptical eye over multiple cot deaths, using an American aphorism as a guide: "One sudden infant death is a tragedy, two is suspicious and three is murder unless proved otherwise."

His stance has, not surprisingly, made him many enemies among groups representing parents who claim to have been wrongfully accused of child abuse and ordinary parents who have suffered a cot death and feel the taint of suspicion upon them.

Two women are already in prison. Donna Anthony, from Yeovil, Somerset, was given a life sentence for supposedly smothering two babies in 1998. Sally Clark was convicted the following year. A third woman is due to go on trial early next year. 

The difficulty of trying such charges is well illustrated by the Clark case. After long deliberation the jury brought back a majority verdict. A conviction for a solicitor such as Clark would normally result in them being struck off. But at a hearing two months ago Clark was merely suspended by the Solicitors' Disciplinary Tribunal, indicating that even seasoned legal minds are troubled by the verdict.

Meadow and like-minded academics are accused of being part of a witch-hunt; but the tactics of their opponents are questionable, to say the least. The organisers of a conference in California, where Meadow spoke recently, were told, falsely, that Meadow was being investigated by one police force for perjury and by another for abusing his own grandchild (who lives in New Zealand). He takes care to keep his address, in rural Yorkshire, confidential.

The hostility toward him and other colleagues, he believes, is fuelled by the fact that they are telling us things we don't want to hear. "Despite the evidence, people still don't want to believe that mothers will hurt their children," he says. "It's more popular to blame paedophiles or talk about stranger danger than to face a truth, that the danger is not walking to school or playing in the park. The place where children are truly at risk is in their own home." 

From a room overlooking a lovingly tended garden, Meadow prepares his files on suspected child abuse cases. He retired from St James's University hospital, Leeds, two years ago but is often called upon to act as an expert witness. Most cases he takes on end up in the family courts, rather than in criminal proceedings, and he says a high proportion turn out to have an innocent explanation.

"People say we're zealots, but what these people don't realise is the number of times we are brought papers and end up saying, 'I don't think this is a suspicious death.' It happens very frequently. Injuries can happen accidentally and I absolutely accept that."

Meadow's first encounter with child abuse was as a paediatric kidney specialist in his early years in Leeds. Two children aroused his suspicion. The first was a six-year-old girl whose urine samples were tainted with blood when taken by her mother, but normal when taken by a nurse. The second was a young boy who had been treated for kidney problems since he was six weeks old. The level of salt in his blood was baffling; it was not explained by any known disorder and nobody could eat or drink that much voluntarily.

  Meadow began to suspect, with no other explanation to hand, that his mother, a former nurse, was force feeding him salt via a nasal tube (years later she confessed that this was what she had done). 

The suggestion was met with ridicule by colleagues. But when he wrote the cases up in a medical journal, he was swamped with other cases from around the world. Overnight, on the basis of these cases of his own, Meadow became an international expert in Munchausen syndrome by proxy.

The extent that people would go to attract medical attention was astonishing. Paperclips and matches were pushed into children's ears to simulate a perforated eardrum, an extremely painful condition. A child went without eating proper food for two years before doctors realised the mother's claim that he could not tolerate solid food was false. One child went blind after having bleach put into her eyes over a long period of time.

Meadow's work has also led him to believe that a small proportion of what we term "cot deaths" are actually murder, particularly multiple deaths. Recent research seems to suggest a genetic link in cot death, but Meadow is sceptical. 

"There is no evidence that cot deaths run in families, but there is plenty of evidence that child abuse does," he says. "Our whole child protection system is geared to protecting brothers and sisters of any child who has been abused because it is recognised that they are at risk. 

"The brothers and sisters in a family where there has been an unsuspicious, well-investigated cot death are deemed to be at very low risk. But there are too many cot deaths that are not well-investigated and even professionals do not recognise the significance."

Meadow would like to see the terms cot death and sudden infant death syndrome (SIDS) abandoned altogether. "What does a cot death actually mean: it is a death for which nobody can find an explanation, natural or unnatural," he says. "Too many people seem to believe cot death is some sort of yet-to-be-discovered germ or syndrome. Instead it should be termed plainly what it is; unexplained death."

He does not believe most cot deaths are suspicious; far from it. Only that unexplained death deserves proper investigation. When he reviewed cot death cases over 18 years, he found several that were written off even though there were plainly suspicious circumstances, such as coins, balls of paper or even a mitten found in the stomach or airways of the child.

The implication is plain. For years, women got away with murder. It is less likely to happen now, partly because pathologists have become better at pinpointing a proper cause of death (he says this is the real reason for the large drop in so-called cot deaths). 

Also, the authorities are less likely to be lenient. If a woman confessed to manslaughter or infanticide years ago, the courts were very likely to hand down a suspended sentence because "she coudn't cope" or "it was a cry for help". "I tend to think there's a lot of truth in that," says Meadow. "These people are no danger to the public and they are often muddled or under enormous strain. I don't mean it's forgivable, but it's understandable. They need help."