Ky. sees increase of babies dying in their sleep

A growing number of Kentucky's infants are dying from unsafe sleep situations, often suffocated while sleeping with an adult impaired by drugs or alcohol, according to a new report by a state oversight panel.

Other small children have died after ingesting drugs left in the home by adults, according to the 2015 annual report by the Child Fatality and Near Fatality External Review Panel.

"It's a huge issue and it's becoming a huge issue because of our growing drug problem," said Dr. Melissa Currie, a University of Louisville forensic pediatrician and a member of the panel. "The number one risk for sleep deaths is substance abuse."

Deaths from unsafe sleep situations were the leading cause of child deaths in cases where abuse or neglect was suspected for the fiscal year that ended June 30, 2014, alarming panel members who warned of the problem in last year's annual report.

In all, the panel determined that of 37 children who died from suspected abuse or neglect, 14 were sleep-related and another two children died from ingestion of drugs. By contrast, physical abuse accounted for five deaths.

The previous year, nine infants died from unsafe sleep situations, seven sharing a bed with an adult, according to the panel's 2014 annual report.

And the panel believes some child sleep deaths involving impaired adults go uncounted because caregivers are not routinely tested for drugs or alcohol when a child dies unexpectedly in their care.

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Among the panel's recommendations is that the state develop a system for uniformly testing adults for drugs or alcohol in such circumstances.

State public health officials recently launched a "safe sleep" campaign aimed at reducing unexpected deaths of children younger than age 1, urging parents to follow the "ABCs of safe sleep for infants" — putting babies to bed alone, on the back, in a crib.  About 85 Kentucky infants suffer unexpected deaths each year.

Currie said public health efforts should  include warnings that an infant is at even greater risk sleeping with an adult impaired by alcohol, illegal drugs or prescription drugs such as painkillers.

"There were just a lot of cases of babies sleeping in bed with a caregiver and those caregivers were under the influence of something," she said.

The panel's role is to review deaths and life-threatening injuries to children from suspected abuse or neglect with a goal of preventing such incidents and recommending policy changes to reduce child deaths and injuries.

This year's report examined 77 cases of deaths or serious injuries to children from suspected abuse or neglect.

The 2015 report is the third annual report for the panel created in 2012  by former Gov. Steve Beshear amid several high-profile child abuse deaths.

Panel chairman Roger Crittenden,  a retired Franklin Circuit Court judge, said that with funding from the General Assembly in 2014, the panel has been able to hire staff and provide a more detailed analysis of individual child death and injury cases that sometimes run to hundreds of pages.

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"I think we're starting to see real progress in terms of recommendations we are comfortable with that should have an impact," he said.

Among the other recommendations of the panel:

» Kentucky should open now-confidential family court proceedings in cases of child abuse, neglect and dependency to allow for more transparency and accountability in the system.

» More education should be provided to young parents and prospective parents about the risk of abusive head trauma, a leading cause of injury or death to infants and young children when they are violently struck or shaken.

» The state should look at better laws on infant car safety and booster seats enforcement, collect data on violations and cite drivers, especially when a child who was not safely restrained in a vehicle is killed or injured in an accident. Also, law enforcement officials should coordinate with social service workers at the Department for Community Based Services, who could investigate whether neglect was a factor if a child was not safely restrained and a driver was drunk or impaired.

» County coroners should be reminded to promptly notify law enforcement and state social services about the death of any child under 18, as required by state law. That would allow police and social workers to investigate the scene, evaluate whether child abuse or neglect may have  been a factor and to assess whether other children in the home are safe. The panel noted that, in some cases, such notification did not occur promptly.

» The state Department for Community Based Services needs to provide more details about the annual report it releases each September listing the number of child deaths and near deaths from abuse or neglect as well as other details such as causes. The annual report often is incomplete because of pending cases, providing "misleading data," the panel found.

» The department also should provide details about worker caseloads - especially the caseloads of workers involved when a child dies or is critically injured. The panel had sought that information from the Cabinet for Health and Family Services but failed to get it, panel members said.

Crittenden, the chairman, said the panel asked for the information in hopes of making a case for more resources for the struggling department, which is plagued by high caseloads and high turnover among social workers.

"The panel really does want to support the workers," he said. "We just have to have the data to do it."

Reporter Deborah Yetter can be reached at (502) 582-4228 or dyetter@courier-journal.com