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August 1968

Sudden Unexpected Death in Infancy Syndrome

Author Affiliations

San Francisco
From the Department of Pediatrics, University of California-San Francisco Medical Center, the Child Health and Development Studies of the Division of Biostatistics, School of Public Health, University of California, Berkley, and the Permanente Medical Group and the Kaiser Foundation Research Institute, Oakland, Calif.

Am J Dis Child. 1968;116(2):115-119. doi:10.1001/archpedi.1968.02100020117001

Nasal obstruction due to mild infection may well be the trigger for apnea and asphyxia in the sudden death (SUD) syndrome in infancy. This hypothesis is based on the well known reluctance of infants to breathe through their mouths. Choanal atresia is a recognized cause of neonatal death. Some babies appear to be almost completely unable to adopt oral respiration and this sometimes persists up to 5 or 6 months of age. These unexpected deaths almost always occur at night, when the infant is unobserved and asleep. The postmortem evidence of infection can account for a collection of nasal secretion.

The records of 28 infants (among 19,000 live births) who died with the SUD syndrome and who had carefully recorded "well baby visits" were reviewed. The findings failed to indicate any physical or immunological defect, allergy, or injury sufficient to account for this terminal event. All deaths occurred at less than 6 months of age.