As director of the National Center for Child Death Review Policy and Practice at the University of Michigan for the past decade, Theresa Covington is a strong advocate for more thorough and professional investigations of infant deaths – and of the local and statewide review boards that have been established to back up those probes and look for trends that might require new public health efforts.

Yet despite some progress, she’s deeply concerned about the quality of infant death investigations. “There’s no rhyme or reason to what medical examiners are diagnosing as SIDS, suffocation, strangulation or undetermined,’’ she said. “The variability is across the country and within the states.”

“We need to combine all the other sudden infant death data with SIDS to get a real sense of what’s going on with infant deaths. With the old SIDS definition, you can’t do anything more with the data as long as the medical examiners and coroners are so subjective.”