Sudden infant death syndrome

Case history

The parents of a 3-month-old previously healthy infant check on the baby because they feel that he has been sleeping longer than usual; he is found apneic and cyanotic. The mother calls the emergency ambulance service and begins CPR. When the ambulance arrives, the baby is still apnoeic, pulseless, and asystolic. The ambulance personnel initiate paediatric advanced life support protocols en route to the hospital without return of spontaneous circulation. Forty-five minutes after initial resuscitative measures began, the baby remains asystolic and further resuscitative measures are discontinued. Questioning of the parents reveals that the baby was healthy that morning, fed well during the day, and had no sick contacts. The baby was taking no medications and the parents deny access to medications. The baby had been growing and developing normally. The parents report typically placing the baby in the prone position for sleeping, as the baby seemed more comfortable and slept better in that position. Both parents are smokers and the mother reports smoking, on average, just over 10 cigarettes a day during the pregnancy.