SUDDEN, UNEXPECTED DEATH IN INFANCY

THE PROBLEM of sudden, unexpected death in infancy (SUD) has become increasingly important in recent years in forensic medicine. Mortality in infancy from well defined causes has rapidly decreased, and the proportion of SUD of unknown cause has, therefore, been still more evident. Today SUD cannot be considered a problem for forensic medicine only; many other branches of medicine have an interest in this problem. In the past SUD has been attributed to suffocation by overlaying, by aspiration of vomitus, or by bedclothes. During the last 10 years it has widely been presumed that SUD is due to an overwhelming viral infection. Although much effort has been spent in an attempt to demonstrate the possible viral agent, the results have mainly been negative. Hypogammaglobulinemia as a possible cause of SUD was indicated by Harboe and Gormsen, and more recently it was suggested that SUD results from an anaphylatic reaction to cow's milk inhaled into the larynx or trachea. Many authors have pointed out that SUD might be connected with rickets or some more obscure kind of disorder in the calcium metabolism, and in 1962 Maresch demonstrated a significantly low content of calcium in heart musculature in these infants and presumed that one and the same basal disorder of metabolism might lead to rickets and spasmophilia as well as to SUD. However different the theories, two facts seem to be generally accepted by all authors in this field. Nearly all claim that SUD is significantly most frequent at the age of about 3 to 4 months.