Cote, from McGill University Health Center in Montreal, and colleagues report that deaths among infants in a sitting position accounted for about 3 percent of the infant deaths they reviewed as part of their study.
"Caution should be used when placing younger infants in car seats and similar sitting devices, whether the infants have been born prematurely or not," Cote and colleagues report in Archives of Disease in Childhood.
"Based on other studies that have looked at the level of oxygen in the blood of infants in a sitting position, as compared to being in bed, I would say one hour at a time should be the maximum," Cote told Reuters Health.
Cote's group conducted a 10-year review, through December 2000, of all sudden unexplained deaths between birth and 1 year of age that occurred in the province of Quebec. They used medical and coroners' records to identify 99 explained deaths, caused by heart-related problems or infections; and 409 unexplained deaths.
Overall, 10 infants in the unexplained death group and 7 in the explained death group died while sitting in a car seat or other sitting device. All other deaths occurred while infants were lying down.
When the researchers accounted for age at death and adjusted for prematurity, they found that 9.4 percent of the infants who died at less than 1 month of age were in a sitting position at the time of death. By contrast, just 2.4 percent of older infants died while in a sitting position.
After reviewing individual cases of young infant deaths, time spent in a sitting position, the presence of airway problems "may have contributed to the death of the infants in a sitting position," Cote and colleagues note.
Recommendations concerning traveling in car seats and the use of infant seats should consider the findings of this study, the researchers conclude.
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