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Yeah, pretty much they don't know.
The ideas they get usually come from the statistical research.
For example:
They have data on X# of babies that died from SIDS. Of that # a greater % that died were found on their tummies. Therefore they recommend that babies be put to sleep on their backs. Not quite as simple as that but just a general example - there is a lot of time and effort going into the research. It's not a totally blind recommendation but the best that can be done without knowing what really causes it. There is a lot more ongoing research.
I say follow the recommendations as best you can and allow for tweaking for your individual baby.
As a mother I know how you feel. I swear I hardly slept at all the first 4 months with my DS - I even woke him up in a panic a couple of times because I thought he wasn't breathing - he was and then I had to try to get him back to sleep - LOL. Get the monitor if it will help YOU sleep - lol. Dads generally seem not to worry as much about this stuff.