Intended for healthcare professionals


Apparently life threatening events in infant car safety seats

BMJ 2006; 333 doi: (Published 07 December 2006) Cite this as: BMJ 2006;333:1205
  1. Shirley L Tonkin, general practitioner1,
  2. Sally A Vogel, paediatric radiologist2,
  3. Laura Bennet, associate professor3,
  4. Alistair Jan Gunn, associate professor4
  1. 1New Zealand Cot Death Association, Auckland, New Zealand
  2. 2Starship Children's Hospital, Auckland, New Zealand
  3. 3Department of Physiology, University of Auckland, Private Bag 92019, Auckland, New Zealand
  4. 4Departments of Physiology and Paediatrics, University of Auckland
  1. Correspondence to: A J Gunn aj.gunn{at}
  • Accepted 20 October 2006

Young infants should not be left unattended to sleep in standard car safety seats

Infant car safety seats are vital to protect young infants from injury and death in motor vehicle accidents.1 Preterm infants and term infants with pre-existing health conditions are at risk of oxygen desaturation and secondary central apnoea while they are restrained in recommended semi-reclining infant car seats.2 3 Recent studies have shown that mild oxygen desaturation can affect some full term infants,4 5 although others found no effect on average saturation.6 None of these studies reported overt apnoea or bradycardia in full term infants during these mild events, but according to anecdotal reports term infants as well as preterm infants have died while in semi-reclined car safety seats.7 8

To further investigate whether or under what circumstances these observations translate to a real risk for healthy full term infants, we prospectively examined all infants referred to the Auckland Cot Monitoring Service after an apparently life threatening event in early infancy.

Case reports

In the 18 months between July 1999 and December 2000 a total of 43 infants were referred to the service for evaluation after apparently life threatening events and were examined by one of the authors (SLT). All infants had been seen on one or more occasions to develop cyanosis or to turn pale, …

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