WESTCHESTER COUNTY Child Fatality Review Team RELEASES
THIRD independent CHILD FATALITY REVIEW REPORT
Westchester County District Attorney Janet DiFiore and County Executive Andrew Spano announced that Westchester County’s Child Fatality Review Team (CFRT) has completed, with the approval of the New York State Office of Children and Family Services, its third independent Child Fatality Review Report.
New York State law requires the Westchester County CFRT to review the death of a child with regard to the services provided by the Westchester County Department of Social Services and agencies under contract with Westchester County and to prepare a mandated report concerning that death.
The Westchester County CFRT has assumed the responsibility of preparing this report mandated by state law and is currently the only county in the state writing the report mandated by SSL Section 20(5)(a). Pursuant to Social Services Law (SSL) § 20(5)(c), this report may only be disclosed to the public by the New York State Office of Children and Family Services (OCFS).
Westchester County was the fourth county in New York State to have an approved CFRT.
The Westchester County CFRT also prepares an independent report in addition to the state mandated report. This report is unique because it is the only independent report written in New York State. The purpose of the independent report is to proactively address matters beyond the scope of those matters required to be examined by state statute, SSL § 20(5)(a). In this case, the independent report concluded that the public would benefit from more information concerning co-sleeping.
The Westchester County CFRT’s third independent report addresses the death of a newborn baby who suddenly died during sleep in Westchester County in June 2006. The body of the newborn baby was discovered by her parents after three family members had gone to sleep with the infant in the same bed the night before.
The independent report findings and recommendations are as follows:
The Westchester County Child Fatality Review Team makes the following findings and recommendations concerning its review involving what appears to have been a preventable death of an infant child less than six months old who had been co-sleeping in a bed with three other occupants. This infant fatality coupled with the leading research of experts in the field of child safety and safe sleeping form the basis of our Team’s efforts to publicize this issue and of the following recommendations:
In 1999 the U.S. Consumer Product Safety Commission (“CPSC”) issued a report promoting safe sleeping for babies. According to the statistics released by that agency in 1999, over the prior seven year period “121 [babies died] due to a parent, caregiver or sibling rolling on top of or against the baby while sleeping.” More than 75% of these deaths were of babies less than three months old. (U.S. Consumer Product Safety Commission, Press Release # 99-175). As the CPSC’s statistics were only based upon incidents voluntarily reported to that agency, the actual number of infant deaths caused in this manner was not ascertainable and appears based upon subsequent events to be underreported.
More recently the Public Advocate for the City of New York in the September 2005 report entitled “A Patten of Preventable Deaths, 2004 Child Fatality Report,”
found that the most frequent cause of preventable infant death was improper sleeping positions and the large majority of these deaths were caused by co-sleeping. The report states that 15 children known to New York City ACS died as a result of co-sleeping in 2004.
The American Academy of Pediatrics (AAP) specifically recommends that parents or caregivers place infants (up to 12 months old) on their backs to sleep; make sure the infant’s head remains uncovered during sleep and do not bundle the infant in clothing and blankets; avoid overheating the infant; and be sure that the infant is sleeping in a safety approved crib.
While the AAP does not specifically recommend against bed-sharing or co-sleeping, the AAP has recognized that this practice creates a risk of infant suffocation by overlying where an adult in the bed is in an unnaturally depressed state of consciousness, such as from alcohol or mind-altering drugs, or if the co-sleeping occurs on a sofa. (AAP, vol. 105, no. 3, March 2000: Changing Concepts of Sudden Infant Death Syndrome: Implications for Infant Sleeping Environment and Sleep Position (RE9946).
The New York State Office of Children and Family Services (OCFS) and the New York State Department of Health (NYDOH) also encourage parents and caretakers to avoid co-sleeping if they are excessively tired, have used medication, alcohol, or illegal drugs. It is warned that the sharing of space with one or more adults or siblings increases the risk of the infant becoming entrapped in bedding or smothered during the shifting that may occur during sleep. (Child Abuse Prevention Section: Back to Sleep and Safe to Sleep at www.ocfs.state.ny.us).
Additional research conducted by the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) recognizes the heightened risk of infant fatality if infants co-sleep or bed share with other children. “Infants who died of SIDS were 5.4 times more likely to have shared a bed with other children . . .” (NIH/CDC, News Release, May 5, 2003, Bed Sharing with Siblings, Soft Bedding, Increase in SIDS Risk).
An infant death attributed to co-sleeping is a preventable death. The Westchester County Child Fatality Review Team will maintain statistics on the incidence in Westchester County of all child fatalities attributed to a co-sleeping situation which are not otherwise attributable to any other cause of death. The death of this infant was the second death attributable to co-sleeping in this County in 2006. Since adult beds and other adult sleeping surfaces (e.g. sofa) are typically not consistent with the recommended sleeping surface for an infant, specifically the use of a firm surface without loose bedding and objects, members of the Westchester County CFRT will participate in training first responders to document and photograph the sleeping surface and the bedding involved in any co-sleeping death. Additionally, Emergency Medical Services, the police, child protective services, and the District Attorney’s Office will be trained to investigate the use of alcohol and drugs by adult co-sleepers.
The Westchester County CFRT joins the national effort to educate the public of the risks of co-sleeping to infants and to encourage safe sleeping practices.
In particular, the CFRT will provide a copy of this report to the hospitals in the County and will encourage the hospitals and pediatricians to specifically warn new mothers about the existence of the known risk of a child fatality when an infant sleeps in a bed with multiple people.
In addition to the efforts of the CFRT, the Westchester Institute of Human Development and the Westchester County Department of Health in conjunction with New York Medical College plan to initiate a study that will comprehensively review all of the sleep-associated fatalities that occurred in Westchester County within a to-be-determined timeframe.
The study is expected to include a comprehensive literature review of sleep-associated fatalities so that Westchester's fatalities can be compared with peer-reviewed published data. The goal of the study is to generate culturally sensitive recommendations and educational materials for use in a pubic awareness campaign.
All materials created in conjunction with the co-sleeping education campaign will be available in both Spanish and English and will be widely distributed throughout the county.
The Westchester County CFRT was formed by the District Attorney and County Executive to thoroughly examine the fatality of any child less than 18 years old who was the subject of a report to the State Central Register of Abuse and Maltreatment or who at the time of death was residing in a foster care placement through the Westchester County Department of Social Services. The team has elected to prepare the SSL § 20(5)(a) State Report which is then approved and issued by OCFS.
Although it did not apply in the subject case, effective December 14, 2006, the CFRT must now also examine the fatality of any child who dies while the Department of Social Services has an open child protective services or preventive services case involving the child or the child’s family. Additionally the Westchester County CFRT also considers the death of any child that is unexplained, undetermined or due to suspicious circumstances.
By law the CFRT includes representatives from the Westchester County District Attorney’s Office, the Westchester County Department of Social Services (Child Protective Services), the Westchester County Office of Medical Examiner, the Westchester County Attorney’s Office, the Westchester County Department of Health, the New York State Office of Children and Family Services, a forensic pediatrician, members of the police department(s) who handled the investigation of a specific case and emergency medical services.
Our local CFRT also includes representatives of the Westchester County Mental Health Department and Victims Assistance Services.