Sleeping with baby can be deadly

Lavonne Holland was breast-feeding her 4-month-old baby, Jacob, in bed at 3 a.m.

“I went back to sleep – I was tired,” she said. She burped Jacob and placed him on his back between her and her son, 2, and daughter, 4, who were sleeping on the other side of the bed.

It was Jan. 4, the coldest night of the year, and they were all trying to keep warm in the Bethel Bishop apartment off Beltline Boulevard. Normally, they didn’t sleep together: Jacob would be in his bassinet.

When Holland woke again, something was wrong with Jacob.

“He wasn’t breathing, his lips were blue,” said Holland, 27. In a panic, she rushed Jacob into the living room, swept clothes from the sofa and tried CPR. It didn’t work. She ran to a neighbor’s to call 911. “I was crying, screaming at the top of my lungs.”

It was too late.

Jacob’s death that morning was the first child death so far this year that Richland Coroner Gary Watts has listed as “Sudden Unexplained Infant Death Syndrome – Unsafe Sleeping Conditions” and something he is working diligently to educate people about.

Last year, there were seven such tragic infant deaths in Richland County. In 2010, six. In 2009, three.

Holland said she wanted to tell her story to keep such a horror from happening to others.

In Jacob’s case, the unsafe sleeping condition was the baby sleeping with other, heavier people in a bed, Watts said. Even the arm or leg of an older child can cover an infant’s airway and cut off his breathing.

Babies under one year can’t move their heads much or push themselves away from whatever is obstructing their airways.

“It is a completely preventable kind of death,” said Watts. He regards such deaths as “tragic, tragic mistakes” in which no charges are brought.

Such a double-ruling – “unexplained” and “unsafe sleeping conditions” means that an autopsy and other evidence have eliminated all potential causes except for an unsafe sleeping environment.

The process of defining infant sleep deaths – of children under 1 year old – has for years been an evolving field.

Most people now know about SIDS – sudden infant death syndrome.

To have a SIDS ruling, three conditions must be met: the baby is otherwise healthy (with no medical conditions that could contribute to a sleep death), an autopsy must turn up no cause of death (such as ingesting a poison), and the baby must be in a safe sleeping environment.

In recent years, infant death investigators have realized that that the third element –sleeping conditions – wasn’t being thoroughly probed.

That’s because a baby found dead is often quickly taken to the hospital by parents or EMTs; it was rare for investigators to try to reconstruct the death scene.

These days, in Richland County, as soon as the report of a dead baby comes in, Watts activates a special coroner’s team that hurries to the house as well as the hospital. As soon as the caregiver is at the house, the coroner’s investigator gently requests the caregiver to re-enact where the baby was when found. To help the caregiver be specific, the investigator gives him or her a life-sized doll, and the re-enactment is videotaped.

The video involving Jacob was taped, with Holland’s consent, within hours of his death.

“I want you to show me exactly everything that took place from the time you went to bed, how you were positioned in the bed, and then, what happened this morning when you woke up,” deputy Richland County coroner Jane Powell says to the camera at Holland’s apartment.

During the five-minute tape, Holland – sometimes weeping – takes Powell into the bedroom where she was sleeping with Jacob and two other children. Holland is holding the doll Powell gave her.

As Powell takes Holland through the incident – asking about clothing Jacob was wearing and a host of other details – she is sympathetic. “I know it’s hard, having three young children,” she says.

“I’ve tried my best,” Holland says tearfully.

“Did you remember rolling over during the night?” asks Powell.

Holland: “I don’t remember.”

At the end, Powell says: “I appreciate you’re doing this. Hopefully it will help us learn what happened.”

Holland: “I want to know what happened. That would make some of my grief go, just to know what really happened.”

Watts said “unsafe sleeping conditions” can be any number of things:

• Infants sleeping in beds between or alongside parents

• Infants sleeping on couches or armchairs

• Infants being in cribs with comforters or pillows

• Infants sleeping with a dog

“That last one is rare, but it has happened,” said Maj. Patsy Lightle, who oversees a State Law Enforcement Division unit charged with investigating and collecting data on child deaths.

Not all coroners are as thorough as Watts.

“Many coroners in smaller counties don’t have the resources or the staff,” said Dr. H. Gratin Smith, a Greenwood pediatrician who chairs the S.C. Child Fatality Review Board, a state panel that monitors deaths of children 17 and younger.

In 2008, the last year for which complete data have been compiled, the board reviewed 27 baby sleep deaths, Smith said.

Most had unsafe sleeping conditions as a risk factor, Smith said.

Watts said he knows many people sleep with infants. “My grandmother did it, my mother did it, and I know I did it. But it’s unsafe. At some point, you have to realize it’s a danger to the infant. If you want to have a child in the room – put him in a bassinet beside your bed.”

Holland said, “Don’t let your kid sleep with you, I don’t care how cold it is.”