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Red Nose Day is a fundraising appeal of the National Child Health Research Foundation. Money raised is put towards the purposes of the Foundation's cot death division, the New Zealand Cot Death Association.

But not a very large proportion of the money raised, it would seem. It's hard to obtain precise information from the Cot Death Association about their fundraising, but according to a North & South article published in April 1997, well over half the sum raised by Red Nose Day 1996 was eaten up by appeal costs.

When one considers that the 1996 appeal raised $750,000, this means that hundreds of thousands of dollars donated by the public wasn't spent on cot death prevention at all - it went into advertising, consultancy fees, and the like. Hardly what the donating public expects.

Of course, my opposition to Red Nose Day isn't based simply on the fundraising per se. I also object because Red Nose Day represents the questionable side of medical research: the pouring of money (in this case, public money) into unnecessary and pointless projects.

Unnecessary because the cause of cot death has already been elucidated. Pointless because all research projects which focus on a medical cause for cot death can be debunked in a few sentences.

Cot death isn't a medical matter. Babies who die of cot death are not ill in the normal sense of the word - a baby's death is not termed a cot death if a medical cause is ascertained. Cot death babies do not die of suffocation. The only possible conclusion, therefore, is that these deaths results from poisoning.

By the mid-1980s I had become convinced as a scientist that cot death was caused by unsuspected and inadvertent poisoning, that the poison was a gas, and that the gas was generated by microbiological activity within the baby's cot. In 1989 a British chemist, working independently from myself, came to the same conclusion and in addition identified the gases concerned.

The gases are phosphines, arsines and stibines, which are among the most poisonous gases known. They are generated from compounds of the elements phosphorus, arsenic and antimony, which are present in almost all baby bedding on the New Zealand market, including sheepskins. When a common (and otherwise harmless) household fungus called Scopulariopsis brevicaulis becomes established in baby bedding, it can react with these compounds and cause the generation of the poisonous gases mentioned above. This mechanism of gas generation was first elucidated in 1892.

Phosphines, arsine and stibines are all "nerve" gases. They shut down the central nervous system; the baby's heart and lung functions cease; and the baby dies.

This discovery, known as the "toxic gas theory for cot death", answers every observation which the medical researchers have recorded about cot death over the years.

For example: Why does overheating babies seem to cause cot death? Answer: Because a rise in temperature accelerates the fungal activity, causing gas generation to increase markedly.

Why does face-up sleeping help to prevent cot death? Because phosphine, arsine and stibine are all more dense than air. They fall away from the mattress towards the floor, so a baby sleeping face up is less likely to inhale them.

Why is cot death far more prevalent among lower socio-economic families than wealthy families? Because poorer parents tend to borrow or buy second-hand mattresses, and to re-use mattresses from one baby to the next. If the fungus is already established in a mattress from prior use when another baby begins using it, gas generation commences sooner and is greater in volume.

The list goes on and on. All the known cot death epidemiology is answered by the toxic gas theory for cot death.

Once it was realised that cot death was caused by gaseous poisoning, the solution to cot death became obvious: separate the baby from the gas. Hence my campaign advising parents to wrap their babies' mattresses in thick, clear polythene or surgical rubber (which do not contain phosphorus, arsenic or antimony) and to stop using sheepskins as baby bedding.

This campaign, which has been enthusiastically adopted by pakeha parents in particular, is achieving excellent results. The cot death rate is plummeting, as the Cot Death Association and others admit.

Cot death is the result of environmental pollution, and the cause is explained not by medicine but by environmental chemistry. So the question arises: is there any place for medical research into cot death?

At this point it is necessary to consider one pivotal statistic: the cot death rate rises from the first baby in a family to the second; and from the second to the third; and so on; and unmarried mothers across the board suffer a very high rate of cot death. This statistic alone refutes any suggestion that cot death has a medical cause.

Take, for example, Dr Shirley Tonkin's current research, which is studying whether the size of babies' airways is linked with cot death. Is Dr Tonkin seriously suggesting that second babies in a family have smaller airways than first babies; and that third babies have smaller airways than second babies; and that - babies of unmarried mothers have very small airways indeed? It's untenable.

Consider another example: Researchers at Otago Medical School are currently looking at the idea that babies die of cot death as a result of inhaling their expired carbon dioxide. The same statistic refutes this: do first babies exhale some carbon dioxide, second babies more, and babies of unmarried mothers even more again?

All medically based theories for the cause of cot death fall over in the face of this statistic about the rising rate from one sibling to the next. But the toxic gas theory explains it perfectly: parents re-use mattresses from one baby to the next, and thus the cot death rate rises from one baby to the next. It's as simple as that.

What, in fact, do the medical researchers say about cot death? The first point to realise is that they don't talk about the cause of cot death - rather, they talk about so-called "risk factors". These have been widely publicised, and basically the message hasn't changed since 1990.

First, some researchers say that breastfeeding helps to prevent cot death. Actually, it doesn't, as the statistics show. Breastfeeding is very common in New Zealand (over 60% of mothers), whereas in Britain the breastfeeding rate is fairly low (under 30%). Yet for years the cot death rate in New Zealand was much higher than that in Britain.

Another "risk factor" trotted out by researchers is smoking in a baby's environment. Of course, a smoky environment is bad for everyone - babies included - but it is patently not the cause of cot death. Smoking was very common in Britain, for example, in the 1930s and 1940s, but the sudden rise in cot death has occurred from the early 1950s onwards. Smoking is still very widespread in certain countries (notably Japan and Russia) where the cot death rate is minimal.

Another publicised risk factor is prone sleeping. Of all the advice disseminated by the New Zealand Cot Death Association, this is only item which has credibility. There is no doubt that face-up sleeping reduces the incidence of cot death.

But face-up sleeping is only a palliative against the toxic gases and it certainly isn't the solution to cot death. In New Zealand particularly, it is not having the desired results, for reasons which are easily explained. Almost all New Zealand baby bedding contains an appreciable amount of phosphorus; and sheepskins frequently contain very high concentrations. Whereas arsine and stibine are much more dense than air, phosphine is only slightly more dense. Thus phosphine is likely to diffuse around a baby's face in the cot - regardless of the baby's sleeping position.

Hence the limited success of face-up sleeping. Yet even though they have been given these explanations and the chemistry described above, the Cot Death Association's message for Red Nose Day 1997 is face-up sleeping. They totally reject the toxic gas explanation about it - but say they can't provide any rationale themselves.

I have never opposed face-up sleeping - it is consistent with and explained by the toxic gas theory. What's more, I have never asked the Cot Death Association to endorse the theory; I have asked them to endorse mattress-wrapping and the disuse of sheepskins as baby bedding. In view of the dramatic reduction in cot death since my mattress-wrapping campaign began, one would think they would listen. Instead they put up objections to mattress-wrapping which are obvious canards.

First, they say that babies sleeping on polythene-covered mattresses might suffocate. Actually, accidental suffocation among babies is extremely rare. Babies can raise their heads from a very young age. Certainly it is possible for babies to suffocate if their faces become trapped in very thin plastic, but the plastic stipulated for mattress-wrapping is thick, clear polythene, at least 125 microns. Babies do not suffocate on a film of this thickness.

The second purported objection to mattress-wrapping is that babies might overheat, and overheating has been identified as a cot death risk factor. The objection is fallacious and demonstrates a lack of knowledge of heat transfer: the insulation provided by a layer of polythene is far less than that provided by any mattress. (It is noteworthy that research in Britain (CESDI study) has found that babies are safer and healthier if they sleep on a mattress with a smooth plastic surface.)

Another stated objection to the toxic gas theory - advanced ad nauseam by medical researchers - is that the toxic gas theory isn't "proved". It's a meaningless statement. As any scientist knows, a proposition of this type can never be "proved" -it can only be disproved. And yet despite seven years' investigation into the toxic gas theory, no-one has disproved it or even been able to advance a valid criticism of it.

The fact is that advice to parents based on the toxic gas theory has caused the cot death rate in New Zealand to plummet over the last couple of years (as it did earlier in Britain). Some researchers try to attribute this recent drop to the advice publicised by the Cot Death Association. But that advice hasn't materially altered for years now; what's new is that parents have wrapped mattresses and stopped using sheepskins.

Why, I am frequently asked, do I face such opposition from the orthodox cot death researchers and the Cot Death Association? Surely we have the same aim, i.e. to save babies lives? I sometimes wonder. Undoubtedly there are those among the orthodox researchers who genuinely wish to eradicate cot death, but I strongly suspect that other agendas come into play as well.

For years now cot death research has been a source of "soft research money" - in other words, it keeps people in jobs.

Furthermore, some researchers would suffer a loss of face if they were forced to admit that the solution to cot death - which the medical establishment worldwide has been researching for decades at a cost of millions of dollars - had been discovered by a couple of chemists.

It is also highly relevant in the New Zealand context that the Cot Death Association has known about the toxic gas theory since 1991. When it was first publicised in this country, Dr Shirley Tonkin, speaking on behalf of the Association, rubbished the proposition outright and told parents not to take any notice.

Dr Tonkin and other orthodox researchers have continued to deny the validity of the theory ever since. But while the debate has raged to and fro, babies have continued to die, and indeed New Zealand has had the highest cot death rate in the world. If the Cot Death Association now admit the validity of the toxic gas theory, they will face severe criticism from hundreds of bereaved parents who have lost babies in the meantime.

Which brings me back to Red Nose Day. I believe that the Cot Death Association have no right to ask the New Zealand public for more funding, while at the same time they refuse to endorse preventive measures which have achieved demonstrable success in both New Zealand and Britain.

I do not believe that any charity has the right to solicit donations from the public and then spend over half the sum on appeal costs.

But my strongest objection to Red Nose Day is that it is a huge barrier to the eradication of cot death in New Zealand. It perpetuates the gravy train. It allows people to set up new programmes, attend conferences, and talk around and around the subject of cot death. It promotes the idea in the public mind that the solution to cot death has not yet been found.

My message to the public is: stop this merry-go-round. The cause of cot death has been discovered. On Friday 15th August, put your wallets away.

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Copyright 1997 by T. James Sprott

Dr T. James (Jim) Sprott, OBE, Msc, PhD, FNZIC
Consulting Chemist, Forensic Scientist
10 Combes Road
Remuera, Auckland 5
New Zealand
Phone/fax: 64-9-523-1150
Email: sprott@iconz.co.nz
URL: www.pnc.com.au/~cafmr/sprott

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