Wednesday, 6 July 2011

SIDS: Ohio statistics: dangers of co-sleeping: "Babies aren't supposed to die"

Mark Gokavi June 25, 2011

Each year about 1,000 infants died in Ohio, and the vast majority did not result in criminal prosecution.
In the Miami Valley, just five of 409 infant deaths from 2007 to 2009 in a seven-county area were classified as homicides. Two-thirds of the deaths were from natural causes, most often prematurity.
The numbers depict two things: Most infant deaths do not include criminal behavior; and even when there is suspicion of a crime, it’s difficult to prosecute.
The Dayton Daily News reviewed the most recent available data provided by the Ohio Department of Health regarding infant deaths in Butler, Clark, Champaign, Greene, Miami, Montgomery and Warren counties. All the cases were reviewed by the Ohio Child Fatality Review Board.
Greene County Prosecuter Stephen K. Haller said infant deaths are difficult to prosecute and especially emotional because “babies aren’t supposed to die.”
A Greene County jury on June 16 acquitted a 26-year-old man who faced manslaughter in the death of his 4-month-old stepdaughter. She died while sleeping on an adult bed. The coroner ruled the cause of death as positional asphyxia.
Haller there is no “bright line” that distinguishes which infant death cases to proceed with criminal charges.
He said his office discusses it in-house before presenting to a grand jury.
“When you have caregivers, parents, circumstances where it may be recklessness or may be negligence or it may be purposeful, sometimes you just have to let the jury make the call,” Haller said. “They are very difficult cases, not only legally and factually, but emotionally for all the people involved.
“Babies aren’t supposed to die.”
Varnell Carter, 26, was acquitted by a jury of child endangering and manslaughter charges in the July 6, 2010 death of his 4-month-old stepdaughter, Reagan Merriweather. He had placed the child inside a U-shaped nursing pillow on an adult bed with a sheet and comforter. Greene County Coroner Kevin Sharrett ruled the cause of death as positional asphyxia.
On June 3, a Warren County grand jury declined to indict Sean McClain, 24, of Lebanon on charges he killed his 3-month-old son Micah while sleeping in his bed.
A month before Merriweather’s death, 4-month-old Cadence Gardner of Caesarcreek Twp. in Greene County died from asphyxia when covers were over her head on a 90-degree day and the house was hot.
The coroner ruled the Gardner death accidental and that case was not prosecuted because Haller told detectives there was “no criminal culpability as it relates to the caretaker.”
The Ohio Department of Health data shows that from 2007 to 2009, there were a combined 156 post-neonatal (from 1 month to 1 year old) infant deaths Butler, Clark, Champaign, Greene, Miami, Montgomery and Warren counties.
Other than the five death certificates listing the manner of death (circumstances surrounding it) as homicide, 66 were from natural causes, 50 were accidental, 66 were sleep-related and 33 were undetermined.
The Ohio Department of Health doesn’t release individual county statistics.
In 2008, the 88 Ohio Child Fatality Review boards looked at 1,655 cases for manner and cause of death of children younger than 18. Among the findings:
• Deaths to infants younger than 1-year-old accounted for 67 percent (1,104) of the reviews.
• Sleep-related deaths (including Sudden Infant Death Syndrome or SIDS) accounted for 15 percent (166) of the 1,104 total reviews for infant deaths.
• 66 percent (109) of the sleep-related deaths occurred in unsafe locations such as adult beds and couches.
• 62 percent (103) occurred to infants who were sharing a sleeping surface with someone else.
“It’s very gray,” said Mark McDonnell, the Greene County health commissioner and co-chair of that county’s Child Fatality Review Board. “Even if you do intensive investigation, it’s very hard to pinpoint exactly what caused a child’s death.”
Ken Betz, director of the Montgomery County Coroner’s Office and the Miami Valley Regional Crime Laboratory, said he doesn’t recall any prosecutions of cases in Montgomery County similar to Carter’s — where the defense argued SIDS and the prosecution only had circumstantial evidence involving bedding.
Testimony by police investigators and medical personnel in the Merriweather case centered on how the infant was placed on her stomach and for how long, and if the sheets and comforter were rumpled underneath the child.
A Montgomery County Child Fatality Review Board report about 1997-2008 noted, “Over the years, death scene investigations and forensic tests have become more sophisticated. This has resulted in a decrease in the number of deaths attributed to SIDS and an increase in deaths attributed to unsafe sleep practices.”
Hamilton County Prosecutor Seth Tiger, who handled McClain’s prosecution due to a conflict of interest in the Warren County Prosecutor’s Office, said a grand jury failed to indict McClain because the coroner could not conclusively determine the cause of death.
“Mikah most likely died because McClain rolled on top of him, but the coroner could not rule out a heart condition or something SIDS related so ultimately we could not prove the case beyond a reasonable doubt,” Tiger said. “Does it seem particularly coincidental that McClain and his girlfriend admit to partying and being high on drugs, the next morning their baby is dead? Yes, but the reasonable doubt was still there.”
Both McClain’s grandmother Marilyn Cosgrove and his attorney Charles Rittgers called the death of Mikah a “horrible accident.”
An accident is also how Carter’s defense attorney characterized Merriweather’s death. “I was surprised that they were bringing this case,” said lawyer Jay A. Adams. “And when I said to the jury, but for the grace of God go I, that’s (for) all of us who have had kids who have ever laid them on their stomach.”
Though criminally cleared, Carter said he learned something that he will employ with he and his wife’s infant daughter, who was born this month.
“Never assume. Never assume because anything can happen with a child,” Carter said. “Children are delicate and you never know what can happen in a matter of seconds.
“I wake up, sometimes if she makes the slightest noise, I just wake up out of my sleep. It’s just a reaction. You just never know.”
Staff writers Justin McClelland and Lou Grieco contributed to this report. Contact this reporter at (937) 225-6951 or

Infant safe sleeping policy
Key points include:
Healthy babies should always sleep on their backs. Because babies sleeping on their sides are more likely to accidently roll onto their stomach, the side position is not as safe as the back and is not recommended.
Require a physician’s note for non-back sleepers that explains why the baby should not use a back-sleeping position, how the child should be placed to sleep, and a time frame that the instructions are to be followed.
Use safety-approved cribs and firm mattresses (cradles and bassinets may be used, but choose those that are JPMA (Juvenile Products Manufacturers Association) certified for safety).
Keep cribs free of toys, stuffed animals, and extra bedding.
If a blanket is used, place the child’s feet to the foot of the crib and tuck in a light blanket along the sides and foot of the mattress. The blanket should not come up higher than the infant’s chest. Sleep clothing, such as sleepers, sleep sacks, and wearable blankets, are good alternatives to blankets.
Place babies to sleep only in a safety-approved crib with a firm mattress and a well-fitting sheet. Don’t place babies to sleep on chairs, sofas, waterbeds, or cushions. Adult beds are NOT safe places for babies to sleep.
Sleep only 1 baby per crib.
Keep the room at a temperature that is comfortable for a lightly clothed adult.
Do not use wedges or infant positioners, since there’s no evidence that they reduce the risk of SIDS.
Never allow smoking in a room where babies sleep, as exposure to smoke is linked to an increased risk of SIDS.
Have supervised “tummy time” for babies who are awake. This will help babies strengthen their muscles and develop normally.
SOURCE: American Academy of Pediatrics

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