Home monitoring in infants at risk of sudden infant death: Suggestions to reconsider current practice

Considering the decreasing incidence of sudden infant death syndrome (SIDS) and the yet unproven efficacy of home monitoring, current indications for home monitoring should be reconsidered. Documented monitoring still appears to be necessary in infants with apparent life-threatening events (ALTE) an d in siblings of two or more SIDS victims. Home monitoring is also indicate d in infants on home oxygen/ventilation or with specific respiratory contro l disorders, but is usually not indicated in asymptomatic preterm infants o r in those with a single SIDS sibling, a mother indulging in drug abuse, or increased parental anxiety. The risk of SIDS in these groups is lower than that in infants of mothers who are heavy smokers, who are nowhere regarded as candidates for home monitoring. If monitoring is considered necessary, new generation pulse oximeters with low false alarm rates are probably the safest technical option because they sound the alarm comparatively early, y et do not give too many false alarms. Home monitor recommendations should b e revisited, taking the above issues into account.