Apparent life-threatening events in infancy.

A previously healthy 5-weekold boy who was born at term is brought to the emergency department. His mother reports that she had placed him on his side with a support pillow after breast-feeding him before she went to take a shower. Upon returning to check on him, she found him in prone position, with his nose and mouth in the mattress, “struggling” to breathe; his face was red. The mother thought he looked “sleepy.” She picked him up, noting his tone was somewhat decreased; she ran his head under cold water with an increase in respiration but he still seemed sleepy. The mother watched him for an hour and breast-fed him. After discussing it with her son’s pediatrician, she brought him to the emergency department (ED). The infant’s medical history is significant for noisy breathing (inspiratory and expiratory stridor) at 3 weeks of age. At that time, he was seen by his pediatrician and by ear, nose and throat (ENT) specialists who diagnosed him with mild laryngomalacia. On exam, he is well-appearing, well-perfused, pink, and in no acute distress. Vital signs are all within normal range. He has mild nasal sounds transmitted to the chest, and mild intermittent inspiratory and expiratory stridor when supine and occasionally Apparent Life-Threatening Events in Infancy