Infant apnoea: a home monitoring programme

A home monitoring programme for infants, thought to be at high risk of cot death, has been conducted in Auckland for the past five years. It has included infants who have experienced an apnoea thought to have been a life-threatening event, infants of very low birth weight, and siblings of infants who died of cot death. The supervision of the 84 infants referred to the programme in 1985 are discussed. The 77 referrals for presumed apnoea resembled the population of cot deaths in Auckland, being predominantly Maori--of low birth weight--between one and four months of age and being identified in the winter months. The mean age of occurrence of the last apnoea was 4 months. There were no deaths, but in 60% of the infants further apnoea was considered to occur and half of these infants required stimulation to recommence breathing. In 11 infants an underlying pathology was later identified as the cause of the initial apnoeic events. Hospital facilities for the investigation and supervision of these infants are inadequate in Auckland at present. The establishment of a fully integrated service for the care of infants at high risk of dying from a cot death is an urgent priority.