Infantile Death by Overlaying: Report of Seven Autopsy Cases

Abstract

Overlaying refers to mechanical asphyxia caused by an adult sleeping on an infant due to deep sleep or external intoxication. We analyzed seven cases (6.6%) of overlaying death out of 106 sleep-related infantile death autopsy cases from January 2018 to March 2021. They were all boys, with an average age of 132.3 (63-244) days, and were sleeping with their inebriated parents. In autopsy, only non-specific findings such as facial congestion, pressure marks, scratches, and froth in the nose and mouth were noted. In the sleep-related infantile death investigation, thorough investigation of the death scene and the previous history are essential for diagnosis, because autopsy findings are minimal or non-specific in most cases. Victims of overlaying and sudden infantile death syndrome show similar clinical and autopsy findings. Therefore, special attention are required for the differential diagnosis.