SINGAPORE — After placing a three-month-old baby in a prone position on an adult bed to help him sleep, his mother fell asleep beside him.
Hours later however, the 31-year-old woman woke to find that the baby had stopped breathing and was blue in the face. Though the mother performed CPR on her son, the baby was unfortunately pronounced dead later that day, on 6 February 2018.
State Coroner (SC) Kamala Ponnampalam gave an open verdict on the baby’s death on Thursday (3 September), as the cause of death could not be ascertained. The woman is currently serving seven-year jail sentence for culpable homicide not amounting to murder. Sentenced on 4 November last year, the woman was found responsible for the death of her two-year-old daughter – she had thrown the girl on the floor – on 9 April 2018, some two months after the death of her baby.
In the current case, while an autopsy report showed no evidence of asphyxia, the cause could not be ruled out. The SC also did not rule out overlaying, which is when a bigger person lies over a small person, resulting in the latter’s death. No injuries were found that pointed to overlaying as a cause of death, noted the SC, who also did not rule out natural disease as a cause.
No drugs or substances were implicated in the baby’s death.
“(The baby’s) death highlights the possible dangers associated with placing an infant in a prone sleeping position or even co-sleeping with the infant in an adult bed (and) parents and caregivers must be aware that certain choices of how they place the infant to sleep places the baby at an increased risk of serious injury or death,” the SC said.
These factors, coupled with the mother’s fatigue, exponentially increased the risk of the baby sustaining an injury, said the SC, who advised mothers to seek help when needed.
According to the SC, three of the woman’s children, including the baby, have died. Besides the two-year-old girl, a four-month-old son died from natural causes on 29 November 2011.
The woman’s surviving son is about 10 years old.
Baby placed in prone position
The baby boy was born prematurely towards the end of 2017 and was admitted to hospital for medical problems, including diarrhoea, in January 2018. He was discharged in the same month.
On 6 February 2018, the woman’s husband left to send the couple’s eldest son to school before heading to work in the morning, leaving the woman with her two-year-old daughter and the baby boy at home.
She fed the baby milk before he fell asleep. As her daughter was also asleep, the woman decided to take a nap as she was exhausted. She slept on the bed beside her baby boy. A while later, she heard the boy cry. After trying unsuccessfully to pat the baby to sleep, she placed him face down with a bolster to support his body, and turned his head sideways on his pillow.
According to the woman, the position was comfortable for the baby and made him fall asleep quickly. The baby fell asleep shortly after, and his mother did so too.
At about 2pm, the woman woke to see her son still in the same position, but with the bolster no longer supporting his body. She saw that his face was against the pillow and turned him to a supine position – lying down on his back with face and torso facing up. She observed that he had turned blue in the face with blood and mucus on his mouth.
She brought the baby to the living room where she called for an ambulance and was instructed to perform CPR on her baby. Paramedics later arrived and took over the process. They observed that the baby’s lips and finger were blue and that he produced no pulse.
When they placed a pad on his chest and back, the baby’s electrical heart rhythm showed a flatline. He was conveyed to Ng Teng Fong General Hospital where he was pronounced dead at 4.13pm.
According to the husband, he was happy with the marriage and did not witness any abuse on the children. He told the court that his wife would sleep late every night due to household chores.
A medical report revealed that although the baby was born prematurely and needed support, he was found to be thriving without abnormalities during follow-up medical appointments. His mother however, had defaulted on a counselling appointment in November 2017 and an eye review for her baby son in December that same year.
A psychiatric evaluation of the mother, conducted when she was remanded for the death of her two-year-old daughter revealed that the mother had Major Depressive Disorder with a history of substance and alcohol abuse. She had the condition before and after the baby’s death.
She indicated that after the baby was discharged in January, his diarrhoea persisted for two days and she was exhausted from caring for him and her daughter. She displayed signs of forgetfulness and was frustrated with the baby’s crying. She also had problems sleeping and poor appetite, as well as low mood.
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