The Sudden Infant Death Syndrome and Apnea/Obstruction During Neonatal Sleep and Feeding

Abstract

Respiratory observations made during nutritive feeding and a complete daytime nap within the 1st wk of life on 10 [human] newborns who subsequently were victims of sudden infant death syndrome (SIDS) were compared to normative data based on 1301 infants of comparable ages. Measurements were obtained of all apneic pauses and/or transient respiratory obstructive events .gtoreq. 2 s in duration. A statistically significant increased number of future SIDS victims had an unusual amount of apnea/obstruction episodes during nutritive feeding when compared to the normative group. Future SIDS victims, as a group, also had an increased frequency of apneic pauses during sleep. All SIDS victims demonstrated an unusual amount of apnea/obstruction during nutritive feeding or apneic pauses during sleep. None of the airway obstruction measures during sleep differentiated the SIDS infants from the normative group. Prolonged apnea or airway obstruction is part of the pathophysiologic process resulting in SIDS. The data implicate unstable respiratory activity during sleep as well as apnea and pharyngeal/laryngeal dysfunction induced by liquid stimulation of the upper airway. Factors that predispose an infant to SIDS originate in the perinatal period.