Head turning and face-down positioning in prone-sleeping premature infants

Background: Term infants may die of sudden infant death syndrome (SIDS) whe n they assume the face-straight-down or the face-near-straight-down head po sitions. Preterm infants have a higher SIDS rate, but it is not known how o ften they assume the face-straight-down and face-near-straight-down positio ns. Objectives: To determine the frequency and cardiorespiratory consequences o f head turning and face-down head positioning in prone-sleeping premature i nfants. Study design: Supervised overnight cardiorespiratory and audiovisual record ings were conducted in 15 prone-sleeping preterm infants nearing hospital d ischarge: birth weight, 1178 +/- 101 (SEM) g, postconceptional age, 40 +/- 1.0 weeks. Results: The preterm infants, studied at a younger postconceptional age tha n previously reported term infants, seldom turned their heads during sleep; therefore they rarely assumed the face-straight-down position (6 episodes in 3 infants) or the face-near-straight-down position (30 episodes in 6 inf ants). Conclusions: Prematurely born infants, known to be at increased risk of SID S, rarely assume face-down positions when sleeping prone at approximately 4 0 weeks' postconceptional age. These results suggest that head turning duri ng sleep is developmentally regulated and may have relevance to understandi ng the age distribution of SIDS.