Unexpected Death in Infants Monitored at Home

Which infants to monitor, for how long, how to decide when monitoring should be discontinued, and how to prevent sudden death in infants for whom home monitoring is recommended: these are controversial questions facing all medical personnel responsible for infants cared for by home monitoring programs. Despite clinical investigations into the causes of infantile apnea and sudden infant death syndrome (SIDS), and despite 15 years of both intervention with home cardiorespiratory monitors and the technological refinement of these machines, there is no definitive proof that the rate of sudden, unexpected infant death has declined. To the contrary, some infants have died despite seemingly adequate efforts to identify those at risk, to intervene with home monitoring, and to instruct caretakers in appropriate cardiopulmonary resuscitation (CPR) maneuvers.^1-3 Yet, no prospective, controlled studies have been published demonstrating that home monitoring has failed to prevent individual sudden infant death or to reduce the