'Near-miss' or 'near-myth' for sudden infant death syndrome? Clinical observations on 57 infants.

A clinical approach to infants who may have 'nearly missed' Sudden Infant Death Syndrome (SIDS) is suggested as appropriate whether or not the eventual conclusion is that there is no connection between these surviving infants and those who die of SIDS. A non-restrictive investigative approach has been applied to 57 infants with episodes causing similar levels of alarm and recourse to medical aid but not exclusively having documented apnoea or need for cardiopulmonary resuscitation. Similarities among patients in past history, recent minor symptoms, modes of presentation and positive investigations support the concept that they may show a common response to a variety of pathophysiologic stresses. Epidemiological similarities to SIDS cases support the suggestion that SIDS may be the end-stage inadequate response to such stresses. Future studies should address the reasons for 'inappropriate' collapse, its treatment and prevention and be alert to any resultant effect upon the incidence of SIDS or further evidence of a link between the conditions.