It would be extraordinary for someone to kill Folbigg children without leaving a mark, says SIDS expert

Content Warning: This article refers to sudden death of children in infancy. Red Nose Australia provides 24/7 Bereavement Services on 1300 308 307.

A world authority on sudden infant death syndrome and a neurologist-turned-parliamentarian have both cast doubt on the proposition Kathleen Folbigg suffocated her four children.

Dr Monique Ryan – now the Federal member for Kooyong – and who presented evidence as a paediatric neurologist at the first inquiry into the deaths in 2019, told the current review her opinion that Patrick Folbigg died after a sudden, unexpected death due to epilepsy had not changed.

When questioned by counsel assisting the inquiry Julia Roy, Ryan affirmed Patrick’s death was likely due to a neurological condition and seizures consistent with Sudden Unexpected Death in Epilepsy.

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“I think more likely than not that he has an as yet uncharacterised epileptic encephalopathy that resulted in progressive neurological dysfunction, and in his death,” Ryan said.

She suggested Patrick’s first experienced seizure occurred during an acute life threatening event when he was three months old. He was then diagnosed with epilepsy and declared blind.

Earlier, Professor Peter Fleming, a world-renowned authority on Sudden Infant Death Syndrome – or SIDS – found no reason to believe any of the Folbigg children were suffocated.

In his reports to the inquiry, he noted it was “hard to accept” that Patrick, Sarah or Laura were smothered and showed no physical signs of it.

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Fleming cited his own experience resuscitating young infants where pressure is unavoidably applied to the face. He suggested it was inconceivable that a suffocated child with eruptive front teeth would have no injury to the inside of the mouth.

He observed that children fight to protect their airway – “they wriggle very, very vigorously” – such that some sort of injury could be expected.

“Anything that pushes the lip onto the teeth – and anything that obstructs the upper airway – would invariably do that, would risk damaging the inside of the lip,” Fleming said.

“And indeed, one of the reasons we sometimes suspect someone’s harmed a child is because find damage [there].”

When questioned by Tom Bathurst KC, presiding over the inquiry, Fleming noted that while he was reluctant to say such events were impossible, he would be “very surprised” if any of the individual children had been suffocated.

Bathurst then asked: “Would you be even more surprised if one particular person managed to smother three children without leaving a trace?”

Fleming: “Absolutely, I would find that extraordinary.”

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“I would find it very, very, very hard to believe that somebody could suffocate them by putting something over their face or obstructing their airway and leave absolutely no marks in any of them.”

Fleming is considered the driving force behind global campaigns to sleep infants on their back in the nineties. The Back to Sleep initiative has led to a more than 80% decline in SIDS deaths in Britain, and similar decreases in Australia and the United States.

I would find it very, very, very hard to believe that somebody could suffocate them by putting something over their face or obstructing their airway and leave absolutely no marks

Professor Peter Fleming

His report to the inquiry also supported the proposition that a novel genetic variant known as CALM2 G114R was potentially pathogenic that could cause sudden unexpected deaths in children.

The inquiry continues this week with expert evidence from cardiac electrophysiologist Dr Dominic Abrams and forensic pathologists Professor Stephen Cordner, Dr Matthew Orde and Dr Allan Cala.

More on the Folbigg inquiries

• Video: Inquiry hears that new evidence puts the conviction of Kathleen Folbigg in doubt
• Folbigg inquiry head must decide on evidence now, “can’t wait for science to fully develop”
• Researchers affirm science behind G114R study
• Why proteins matter
• Scientists grilled on advocacy and accuracy
• Calmodulin variants “not benign” say Danish experts