In spite of Federal guidelines and warning labels, there still are older, unsafe cribs and mattresses in use. An adult lying on the child has been cited as a cause of sudden infant death since the time of King Solomon and, therefore, co sleeping should be discouraged. Regurgitated materials and feces on the bedding can cause increased growth of microbials that may adversely affect the infant. The temperature in the baby's immediate environment is a critical factor. Over-wrapping and exposure to direct heat cause hyperthermia, which is known to induce abnormalities of ventilatory control and brain stem dysfunction.
Sweat glands are active in the baby's scalp and scalp sweating can be used as a clinical indicator.
Primary care givers should routinely ask parents regarding scalp sweating. A deficit of the arousal and gasping mechanism follows the brain stem dysfunction. It is well recognized that pediatric upper airways are narrower than adults. Swelling of the airway mucosa frequently occurs from irritation and infection. The inhibition of monosynaptic reflexes during REM cause laxity of upper airways, which in turn aggravate the apneic states.