Disorders of Unknown Etiology

Question 1

What is Sudden infant death syndrome (SIDS) and what infants are at risk?

Answer 1

sudden, unexplained death of infant < 1 year

Infants at risk:

• Low birth weight
• Low Apgar scores
• Recent viral illness
• Siblings of two or more SIDS
• Male
• Native American or AA

Question 2

What are some practices that may reduce the risk of SIDS?

Answer 2

• Avoid smoking during pregnancy and near the infant
• Breast-feeding
• Supine sleeping position
• Avoid soft, moldable mattresses, blankets, and pillows
• Avoid bed sharing
• Avoid overheating during sleep
• Vary infant head position to prevent plagiocephaly (flat head)

Question 3

What is Apnea of prematurity?

Answer 3

Cessation of breathing longer than 20 seconds, or any period with bradycardia and cyanosis not associated with any predisposing conditions

Question 4

What is Apnea of infancy and what can cause it?

Answer 4

• Unexplained respiratory pause lasting 20 seconds or more OR
• Less than 20 seconds accompanied by pallor, cyanosis, bradycardia, or hypotension (term infant)

Can be symptom of other disorders:

• sepsis, sz, neurologic, upper/lower airway infection/abnormalities, GER, metabolic disorders, impaired regulation of breathing during sleep, result of intentional harm by caretaker

Question 5

How would you manage infants with apnea?

Answer 5

• Treat underlying condition
• Recurrent apnea: home monitoring
• Methylxanthines (theophylline, caffeine)
• CPR training
• Family Support