Hampton, NN part of expanded Child Fatality Review

March 29--"Undetermined" sudden child deaths in Hampton and Newport News are coming under expanded review through a grant received from the U.S. Centers for Disease Control by the Eastern Region Child Fatality Review Team in partnership with the Virginia Department of Health.

Nationwide, more than a dozen states and localities will participate in the "Sudden Death in the Young Project."

"I'm so tired of writing 'undetermined,' and saying 'I don't know,'" said forensic pathologist Wendy Gunther, assistant Chief Medical Officer in Norfolk, who is the medical leader of the local team in the four-year pilot program. She was speaking Friday at the annual release of the Eastern Region Child Fatality Review.

Actually, for the most part, the pathologist who has performed more than 4,000 autopsies in her career, believes she does know.

The vast majority of unexplained deaths in otherwise healthy infants result from unsafe sleep practices, she said.

In Hampton Roads there were 15 "unsafe sleep" deaths -- preventable deaths not caused by abuse or neglect -- during the year ending June 2014, according to Gail Heath Davidson, chair of the Child Fatality Review team.

"We think they suffocate when the baby turns its head into the mattress, particularly if it's soft, and then can't turn it back," said Gunther.

She blames the influential late pediatrician and author Dr. Benjamin Spock with advising parents to put babies to sleep on their stomachs for fear of reflux. She attributed several thousand sleep deaths nationwide over decades to this practice.

"Laying babies belly down to sleep kills 4,000 babies a year," Gunther said. "It's like putting a chloroform pad over the nose. They go so quick."

She repeated a simple "ABC" mantra to drive home the importance of safe sleep practices: Alone, lying on their Back, in a Crib.

If that was practiced uniformly, Gunther believes she would "probably do two autopsies a year on children that shouldn't die."

But then there are still others that die inexplicably, when unsafe sleep is not a contributing factor.

Under the expanded review allowed by the CDC grant, Gunther and her team will examine "undetermined" child deaths, in those where there are no unnatural circumstances and no underlying disorders.

In addition to an ultra-detailed autopsy, Gunther will send a tiny liver sample of the deceased to be stored at a bio-repository at the University of Michigan for further study.

She will coordinate her efforts with a pediatric cardiologist and neurologist, supplemented by detailed interviews with the parents and thorough analysis by the Eastern Region Child Fatality Review Team. The team is the longest-established in the state and has received numerous awards for its work in reducing child fatalities, said Davidson.

The grant covers four cities in the region, including Norfolk and Virginia Beach. Together with Hampton and Newport News, they account for about 20 to 30 undetermined deaths annually.

Already this year, two have come under the expanded review.

The National Institutes of Health is another partner in the effort, said Virginia "Ginny" Pell, who wrote the initial grant. The NIH will bring in more resources in the grant's third year to analyze data and determine any "cluster of factors," according to Pell.

"I hope we're going to find answers. Maybe we can bring it [undetermined deaths] to zero. That's the dream I'd like to retire on," said Gunther.

Salasky can be reached by phone at 757-247-4784.

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