The study found clear variations in established SIDS diagnostic protocols among Mississippi coroners; however, how these variations affect the SIDS rates in Mississippi is not clearly understood and requires further research. The level of education and training for county coroners poses a significant barrier to consistent implementation of SIDS policies and protocols, even given the improvements in the Centers for Disease Control form. Standardized education should be mandated for coroners, with an emphasis on the importance of the accurate diagnosis of SIDS cases in addition to other suspicious child deaths. Although State law mandates the procedure for SIDS diagnosis, there is no oversight and no penalties enforced for not following the law. The feasibility of a fine for not following the protocol should be considered. Nurses should become involved in direct advocacy efforts toward policy changes. In addition, the study shows the need for national and international standardized protocols and definitions for use in identifying SIDS as a cause of infant death. The CDC guidelines call for an autopsy, death-scene investigation, family interview, and medical-record review before a diagnosis of SIDS can be made. These guidelines should be strictly followed by all U.S. States and territories, so as to maintain comparable and more accurate SIDS for future research. Survey questionnaires were distributed between August and October 2006. Eighty-two questionnaires were distributed, and 49 were completed and returned, for a response rate of 60 percent. 1 table, 29 references, and appended survey questions