Unsafe sleeping environments were identified as the leading cause of preventable infant deaths in Connecticut according to a multi-year review of child fatalities which reported Fentanyl intoxication for the first time as a factor in the deaths of babies and toddlers.
The report, released Tuesday by state Child Advocate Sarah Eagan and Yale pediatrician Dr. Kirsten Bechtel, reviewed the deaths of 97 children younger than three years old that occurred between January 1, 2019, and August 8, 2022 from non-natural causes.
Of the 97 deaths in the 3.5 year period, more than half of the children were younger than three months old. Twenty were ruled to be accidents and 14 were determined to be homicides. The remaining 63 fatalities were listed as having undetermined causes.
However, reviews of those cases often identified risk factors involving unsafe sleeping conditions including infants sleeping on their stomachs or sides, sleeping in beds with other people, or sleeping with loose items like blankets or pillows.
“The American Academy of Pediatrics recommends that infants sleep in their own sleep space, on their backs, with nothing else in the sleep space,” Eagan said in an interview Tuesday. “No blankets, no pillows, no toys, no bumpers, nothing plush or cozy. The sleep space should be in the same vicinity or room as their caregiver.”
Unsafe sleeping conditions are a persistent risk factor present in child deaths. Despite years of efforts by several state agencies, sleep-related child fatalities have not declined in the past decade, according to a Tuesday press release.
The report includes a number of recommendations to curtail infant and toddler deaths including strengthening a public awareness campaign on safe infant sleeping conditions.
The report also found that the children who died between 2019 and 2022 were disproportionately Black and Hispanic and disproportionately male.
The children came overwhelmingly from lower-income families. According to a review of state agency data, 81% of the children who died were enrolled in Medicaid and more than half received nutritional assistance programs.
The report’s authors called for expanding access to support services for families like paid family leave, child care services, and stable housing. Infants who have less access to prenatal care and after birth support are more at risk for preventable deaths, Eagan said.
“The answers are societal. They’re services and support, home visiting, health care, tobacco cessation and substance abuse treatment,” she said.
For the first time, Tuesday’s report identified Fentanyl intoxication as a cause of death in eight of the 14 fatalities determined to be homicides. Although officials continue to review how the children ingested the drug in these cases, the report said that breast-feeding was not a mechanism for ingestion of Fentanyl.
Since even tiny amounts of the substance can be fatal to an adult, Eagan said trace residue can pose a dire threat to an infant.
“You can only imagine how little it takes to be lethal,” she said. “It may be on a baggy that somebody touched, it’s on a spoon that somebody has used to mix formula that maybe wasn’t washed. It may be on a countertop, on clothing.”
Connecticut children experienced near-fatal overdoses in more than 20 other cases between June of 2021 and May of this year, according to the report. First responders and health care providers successfully administered Naloxone in many of the cases in which children survived opioid ingestion, the report said.
Despite recent efforts to require home visits by nurses and expand access to family leave, Eagan said that Connecticut had “a long way to go” if it wanted to eliminate preventable child fatalities.
“We need to hold ourselves accountable for those improvements,” she said. “The state should have a very clear plan to prevent infant – toddler fatalities, taking action on some of the items in our report, and giving ourselves a report card… so that we know over two years, four years, six years, we’re making progress and not still staring at these same problems five years from now.”