Critical diaphragm failure in sudden infant death syndrome 121 be dangerous only in conjunction with other factors. Yet, diagnosing an apparently ‘non-lethal’ infection as the cause of death is by deﬁnition a contradiction in terms. In a sense, a SIDS diagnosis reﬂects the failure to understand that apparently ‘minor’ infections can be fatal to some infants in certain circumstances. If the causes of infant mortality can be accurately ascribed, SIDS may no longer be needed as a diagnosis.This goal should be pursued in the spirit of Fearn’s original question. Acknowledgments The authors dedicate this work to the memory of Pirkko and Jorma Gallen-Kallela. We also wish to acknowledge the critical role of information technol- ogy in enabling and empowering the revolution in global collaborative innovation. Our research would not have been possible without it. Declaration of interest: The authors report no conﬂicts of interest. The authors alone are responsible for the content and writing of the paper. References 1. Fearn SW. Sudden and unexplained death of children. Lancet. 1834;23:246. 2. Kinney HC, Thach BT. The sudden infant death syndrome. N Engl J Med. 2009;361:795–805. 3. PubMed search 15 October 2010. 4. Siren PMA, Siren MJ. Systemic zinc redistribution and dyshomeostasis in cancer cachexia. J Cachexia Sarcopenia Muscle. 2010;1:23–33. 5. Sullivan FM, Barlow SM. Review of risk factors for sudden infant death syndrome. Paediatr Perinat Epidemiol. 2001;15: 144–200. 6. Guntheroth WG, Spiers PS. The triple risk hypotheses in sudden infant death syndrome. Pediatrics. 2002;110:e64. 7. Mitchell EA. SIDS: past, present and future. Acta Paediatr. 2009;98:1712–19. 8. Moon RY, Horne RS, Hauck FR. Sudden infant death syndrome. Lancet. 2007;370:1578–87. 9. Hunt CE. The cardiorespiratory control hypothesis for sudden infant death syndrome. Clin Perinatol. 1992;19: 757–71. 10. Fleming PJ, Levine MR, Long AM, Cleave JP. Postneonatal development of respiratory oscillations. Ann N Y Acad Sci. 1988;533:305–13. 11. Thach BT. The role of respiratory control disorders in SIDS. Respir Physiol Neurobiol. 2005;149:343–53. 12. Waggener TB, Southall DP, Scott LA. Analysis of breathing patterns in a prospective population of term infants does not predict susceptibility to sudden infant death syndrome. Pediatr Res. 1990;27:113–17. 13. Schechtman VL, Harper RM, Wilson AJ, Southall DP. Sleep apnea in infants who succumb to the sudden infant death syndrome. Pediatrics. 1991;87:841–6. 14. Poets CF, Meny RG, Chobanian MR, Bonoﬁglo RE. Gasping and other cardiorespiratory patterns during sudden infant deaths. Pediatr Res. 1999;45:350–4. 15. French JW, Beckwith JB, Graham CB, Guntheroth WG. Lack of postmortem radiographic evidence of nasopharyngeal obstruction in the sudden infant death syndrome. J Pediatr. 1972;81:1145–8. 16. Goldwater PN. Intrathoracic petechial hemorrhages in sudden infant death syndrome and other infant deaths: time for re-examination. Pediatr Dev Pathol. 2008;11:450–5. 17. Guntheroth WG, Kawabori I, Breazeale DG, Garlinghouse LE Jr, Van Hoosier GL Jr. The role of respira- tory infection in intrathoracic petechiae. Implications for sudden infant death. Am J Dis Child. 1980;134:364–6. 18. Pubmed search 15 October 2010. 19. Muller NL, Bryan AC. Chest wall mechanics and respira- tory muscles in infants. Pediatr Clin North Am. 1979;26: 503–16. 20. Macklem PT. Respiratory muscles: the vital pump. Chest. 1980;78:753–8. 21. Celli BR. Respiratory management of diaphragm paralysis. Semin Respir Crit Care Med. 2002;23:275–81. 22. Anraku M, Shargall Y. Surgical conditions of the diaphragm: anatomy and physiology. Thorac Surg Clin. 2009;19:419–29. 23. Roussos CS, Macklem PT. Diaphragmatic fatigue in man. J Appl Physiol. 1977;43:189–97. 24. Rochester DF. Respiratory muscles and ventilatory failure: 1993 perspective. Am J Med Sci. 1993;305:394–402. 25. Nichols DG. Respiratory muscle performance in infants and children. J Pediatr. 1991;118:493–502. 26. Arora NS, Rochester DF. COPD and human diaphragm muscle dimensions. Chest. 1987;91:719–24. 27. Rehan VK, Laiprasert J, Wallach M, Rubin LP, McCool FD. Diaphragm dimensions of the healthy preterm infant. Pedi- atrics. 2001;108:E91. 28. Watchko JF, Mayock DE, Standaert TA, Woodrum DE. Postnatal changes in transdiaphragmatic pressure in piglets. Pediatr Res. 1986;20:658–61. 29. Muller N, Gulston G, Cade D, Whitton J, Froese AB, Bryan MH, et al. Diaphragmatic muscle fatigue in the new- born. J Appl Physiol. 1979;46:688–95. 30. Keens TG, Bryan AC, Levison H, Ianuzzo CD. Developmen- tal pattern of muscle ﬁber types in human ventilatory muscles. J Appl Physiol. 1978;44:909–13. 31. Watchko JF, Mayock DE, Standaert TA, Woodrum DE. The ventilatory pump: neonatal and developmental issues. Adv Pediatr. 1991;38:109–34. 32. Callahan LA, Supinski GS. Sepsis-induced myopathy. Crit Care Med. 2009;37:S354–67. 33. Friman G. Effect of acute infectious disease on isometric muscle strength. Scand J Clin Lab Invest. 1977;37:303–8. 34. Supinski GS, Vanags J, Callahan LA. Effect of protea- some inhibitors on endotoxin-induced diaphragm dysfunction. Am J Physiol Lung Cell Mol Physiol. 2009;296:L994–1001. 35. Supinski GS, Ji X, Callahan LA. The JNKMAP kinase path- way contributes to the development of endotoxin-induced diaphragm caspase activation. Am J Physiol Regul Integr Comp Physiol. 2009;297:R825–34. 36. Supinski G, Nethery D, Stofan D, Di Marco A. Comparison of the effects of endotoxin on limb, respiratory, and cardiac muscles. J Appl Physiol. 1996;81:1370–8. 37. Supinski GS, Nethery D & Di Marco AF. Endotoxin induces free radical mediated diaphragm and intercostal muscle dysfunction. Am Rev Respir Dis. 1993;148:1318–24. 38. Boczkowski J, Lanone S, Ungureanu-Longrois D, Danialou G, Fournier T, Aubier M. Induction of diaphrag- matic nitric oxide synthase after endotoxin administration in rats: role on diaphragmatic contractile dysfunction. J Clin Invest. 1996;98:1550–9.