Gastroesophageal reflux in the “near miss” sudden infant death syndrome

Abstract

S U D D E N I N F A N T DEATH SYNDROME is the largest single cause of death between one week and one year of age. 1 Although there is no agreement about the cause of death, a number of epidemiologic factors have been associated with the syndrome. Surveys 1-' have shown that the peak age incidence occurs between two and four months and that there is a preponderance of male deaths. Death often occurs during periods of supposed sleep, but signs of a terminal struggle are frequently present. Some series note a preponderance of cases in the winter months, possibly related to an increased incidence of viral respiratory disease. The syndrome occurs more commonly in infants from a low socioeconomic environment; a history of cigarette smoking by the mother, young maternal age, and poor prenatal medical care are also common. Familial clustering of SIDS cases has been noted. 2 It has recently been emphasized that future SIDS victims have many abnormalities in body functions, especially respiration and feeding? There is another group of patients labeled near miss SIDS. These infants have sudden episodes of cyanosis and