Dear Editor,

Simply 2 questions for 3 keywords.

First, were there concurrent recordings of associative movements in the prone position? The prone position has been implicated as a risk factor for years yet research has been lying prone on it as a blanket description for just as long. Is it the prone position per se which is at risk? Or, could it be the base point from which a series of movements is initiated to impact the system and result in SIDS?

Secondly, is there a valid analogy with animals which curl up to hibernate in winter with drastically reduced body temperature, cardiorespiratory rate and brain wave activity? Some cellular and molecular responses are well known but it is not the mechanism of hibernation. The physical manoeuvre in combination with the wintry cue may somehow stun the brain.

There is an obvious similarity to SIDS suggesting a parallel pathogenesis. Whereas it is temporary and reversible with spontaneous arousal for hibernating animals, SIDS may represent the irreversible endstage of near-death parameters. Among other factors the low birth weight observed could contribute to the physical accommodation and a generally increased vulnerability.

(No competing financial interest is declared).