Open verdict on cause of baby’s death, mother now in jail for killing elder daughter

• A mother placed her son in a prone sleeping position, saying it made him comfortable
• The boy, who was born premature, was not breathing when she woke up
• Two months later, the mother-of-six killed her older daughter by throwing her to the ground twice

SINGAPORE — A housewife woke up from a nap to find her three-month-old son blue in the face and not breathing.

The boy’s cause of death could not be ascertained but he could have died from being accidentally smothered while his mother, then 28 years old, slept beside him.

This was the finding from the court, as State Coroner Kamala Ponnampalam recorded an open verdict on Thursday (Sept 3) after an inquiry.

She added that there was no reason to suspect foul play. 

The boy’s death highlights the potential dangers of placing a baby in a prone sleeping position or sleeping with a baby in an adult bed, she said.

“Parents and caregivers must be aware that certain choices of how they place their infants to sleep may result in an increased risk of serious injury or even death. When this is coupled with maternal fatigue, the risks are exponentially increased,” the coroner warned.

The mother, now 31, is serving a seven-year jail term meted out in November last year by the High Court. She cannot be named to protect her children’s identities.

She had pleaded guilty to throwing another of her children to the ground twice, ultimately killing the two-year-old girl. 

She was upset because the toddler had defecated on a towel and constantly cried.

This happened on April 9 in 2018, just two months after the boy died on Feb 6.

A psychiatrist found that even before the baby boy’s death, the mother was suffering from major depressive disorder, with a history of alcohol and substance abuse.

She was labouring under these conditions when she killed her daughter as well. 

The health problems substantially impacted her mental responsibility, but she was not of unsound mind at the time she hurt the girl and was aware of the nature of her actions.

Aside from these two children, at least two others have died. She had six children in total.

One died of a viral infection in 2011 when he was four months old. Another son died two days after being discharged from hospital because he had been prematurely born and was frail.

THE LAST SLEEP

During the coroner’s inquiry, the court heard that the mother was alone with her baby boy and his older sister at home. Her husband had taken their 10-year-old son to school.

The baby was born premature, with his mother nearly suffering a miscarriage 18 weeks into the pregnancy. 

That morning, she fed the baby some milk and he fell asleep. After her daughter fell asleep in the living room, the mother felt exhausted and decided to take a nap.

She heard the baby crying a little while later but was too tired to get up. He continued crying when she tried to pat him to sleep, so she placed him chest-down with a bolster supporting his body. 

She said this sleeping position made him comfortable and he would fall asleep quickly.

When he fell asleep shortly after, she slept as well.

Later at 2pm, she woke up and saw the baby’s face “against the pillow”. Upon turning his body, she saw that his face had turned blue, with blood and mucus around his mouth. 

She then called for an ambulance and performed cardiopulmonary resuscitation under the operator’s guidance, before paramedics arrived and took over.

However, the baby was pronounced dead at Ng Teng Fong General Hospital.

FEARS OF LOSING BABY

The woman’s husband testified that she slept “very late” every night after completing household chores.

The month before, the baby boy had been treated for vomiting, diarrhoea and fever at KK Women’s and Children’s Hospital (KKH). Doctors conducted extensive tests, diagnosed him with gastroenteritis, and discharged him after he recovered.

When he was born, he weighed 1.32kg and had several health issues.

His mother told a psychiatrist that she had no one to confide in and perceived that her husband did not want to listen to her fears of losing the baby.

Then she defaulted on a counselling appointment and an eye review for the infant.

However, the boy was later observed to be thriving and reaching milestones appropriate for his age.

MOTHERS SHOULD REACH OUT FOR HELP

Dr Chan Shijia, a forensic pathologist from the Health Sciences Authority, stated in her autopsy report that asphyxia or overlaying — when a bigger person lies over a smaller person — could not be ruled out as a cause of death.

It was also possible that the infant died from natural disease, Dr Chan said.

A medical report from KKH stated that parents of newborn babies are not advised to place infants in a prone position, as there are risks to it. Premature babies are placed like this in the hospital only under strict monitoring.

Due to the number of variables in the case, it was “impossible” to determine the cause of death, State Coroner Kamala said.

“Mothers should be advised and encouraged to reach out for help and support when their duties as a homemaker and caregiver for the family and children begin to take a toll on their well-being,” she added.