Singapore: The State Coroner has stressed the importance of safe sleeping practices for infants after recording an open verdict on the death of a seven-week-old boy found face down on a pillow.
State Coroner Adam Nakhoda said it was unclear whether the baby died from asphyxia or natural causes but highlighted the significance of safe sleeping arrangements. An expert noted that accidental suffocation is a preventable cause of infant deaths.
Safe Sleeping Guidelines
- Avoid placing loose items like pillows, blankets, and toys around or under a sleeping infant.
- Let infants sleep alone in a baby cot.
- Use a firm mattress with a fitted sheet and no gaps between the mattress and cot rail.
- Place infants on their backs for sleeping until they are one year old. Babies over four months who can roll over on their own can sleep in the positions they assume.
The Case
The baby, born prematurely at 35 weeks on May 17, 2023, weighed only 2.14kg. He was initially cared for in a special care nursery and later in the neonatal intensive care unit at KKH Women’s and Children’s Hospital. He was discharged at two weeks old.
At home, the baby primarily received care from his mother and was bottle-fed every two to three hours. Initially, he slept in a cot in his mother’s room, but frequent waking led to his relocation to another bedroom with his father. The baby then slept on a mattress on the floor while his father slept on an elevated bed.
Events Leading to the Death
On July 3, 2023, around 10 pm, the baby’s father fed him and placed him in his usual sleeping position on the mattress. The baby was likely swaddled. The father slept on the bed next to the baby.
Around 5:30 am, the father woke up and found the baby face down on the pillow, unresponsive, with a weighted bean bag still on him. The father attempted to wake the baby but found him stiff and cold. The mother, trained in infant first aid, administered CPR while the father called for an ambulance. Paramedics pronounced the baby dead later that morning.
Investigation and Findings
An autopsy could not determine the final cause of death. Asphyxia could not be ruled out, nor could a natural disease process. Photos showed the mattress was a thin adult-sized one, with creases and ridges from a loosely fitted sheet, and placed against an elevated bed with soft toys and pillows nearby.
The coroner noted that losing a child is devastating, especially when the child is so young. Despite the baby’s initial medical issues, he had been thriving at the time of his death. The coroner extended his condolences to the parents.
Conclusion
The State Coroner emphasized that while it is unclear how the baby ended up lying prone, safe sleeping practices are crucial to prevent such tragedies. He urged parents to follow guidelines to ensure infant safety during sleep.
