Four risk factors for overheating were sought in the histories of 34 cot-death victims in Oxford and Scarborough. 19 babies were unusually hot or sweating when found dead; 14 died in an unusually warm environment; 17 had evidence of a terminal infective illness; and 24 were excessively clothed or overwrapped. 3 babies had all four risk factors, 8 had three, 17 had two, and 4 had one risk factor. Only 2 had no risk factor; both had had very low birthweights. In 6 of 15 babies (40%) whose rectal temperature was recorded after death the temperature was above 37°C, the highest being 42°C. If parents could be educated to anticipate the dangerous situations preceding febrile apnoea, many cot deaths could probably be avoided.
Department of Paediatrics, Scarborough Hospital, Scarborough, Yorkshire YO12 6QL, United Kingdom