Pattern of illnesses before cot deaths.

The reasons for referral to hospital of 147 babies subsequently included in the DHSS study of postneonatal infant mortality were analysed and compared with those of 104 control infants. Although similar numbers were seen as outpatients, 71 (16%) of the babies who died unexpectedly, but only 28 controls had previously been admitted to hospital. The excess was explained by acute infections, loss of consciousness, possible child abuse, and failure to thrive for non-organic reasons. The average length of admission was almost twice that required by controls, and 31% were admitted more than once. The admissions were often clues to important family problems that might have been investigated further. There were no admissions for unexplained apnoea and 'near miss' cot deaths may not therefore represent a suitable model for the investigation of most unexpected deaths during infancy.