Management of infants with apnea and potential apnea. A survey of pediatric opinion.

Conflicting opinions and inadequate data have led to confusion regarding the relationship of sudden infant death syndrome (SIDS) and infantile apnea. Consensus regarding appropriate evaluation and management strategies for infants presumed at risk has not been reached. This study surveyed pediatric opinion regarding these issues. Questionnaires were mailed to 1000 randomly selected members of the American Academy of Pediatrics, and to faculty at all approved U.S. pediatric residency programs. Results indicated that respondents as a group were uncertain about the relationship between SIDS and apnea. Most respondents would (1) initially evaluate infants presenting with apnea at either a hospital or an apnea evaluation center, (2) refer subsequent siblings of SIDS infants to an apnea center, and (3) recommend no intervention, but provide reassurance, to anxious parents requesting a "test for SIDS" for a normal newborn. Respondents' comments showed diverse opinions regarding appropriate evaluation and management strategies for these three types of infants, and reflected concern regarding dilemmas posed to clinicians responsible for their care. Further research and continuing medical education efforts are needed to reduce current confusion.