Baby died a day after being discharged, inquest finds

A six-day-old baby who social workers planned to take into care died a day after he was discharged from hospital, a court has found.

The boy was born at the Rotunda Hospital in 2015, where he was closely monitored for withdrawal symptoms for five days following his birth.

Dublin Coroner’s Court heard his mother had been through a detox programme and was being prescribed methadone.

Her urine samples throughout pregnancy were clean, apart from one sample that tested positive for opiates a week before the baby’s birth.

The baby displayed no symptoms of withdrawal and neonatal ward staff reported to social workers that both mother and baby were doing well.

“She was doing really well in caring for the baby and there were no concerns,” the mother’s principle social worker told the court.

Two social workers involved in the case met the mother in hospital the day before mother and baby were discharged to inform her of the intention to seek an interim care order.

There was no immediate concern for the baby’s wellbeing, the court heard, but there were long-term concerns regarding “environments the mother might find herself in”.

At the meeting with the social workers, the mother “went quiet and began to cry”, the court heard.

After being told that, if the interim care order was refused, Tusla would seek a supervisory care order, the mother became “angry”.

“She said we were taking her baby and not giving her a chance,” a social worker told the court.

After five days in hospital, mother and baby were discharged and returned to the woman’s home, where preparations for the arrival of the baby had been checked by social workers.

Daily visits from the social care team were to form part of the immediate care plan for the baby.

The mother, who was taking 80mls of methadone daily, along with an anti-depressive sleeping tablet, took a taxi home from the hospital with the baby at about 4pm on the day they were discharged.

That evening she fed and changed her baby as normal.

“He was drinking his bottles and seemed fine,” she said.

At about 3am she fed the infant for the last time.

“He fell asleep in my arms. I put him into his Moses basket and put it beside my bed. I had my hand resting on his little blanket,” she said.

When she woke up the next day, she saw that the child had turned blue.

She phoned for an ambulance. Dublin Fire Brigade logged the call at 2.15pm.

A public health nurse arrived at her door at the same time as paramedics.

Resuscitation attempts failed and the baby was pronounced dead at the scene.

Postmortem results

A postmortem revealed subtle changes in the brain that can be associated with a predisposition to Sudden Infant Death Syndrome (SIDS), the inquest heard.

Consultant neonatologist Dr David Corcoran said the preferred feeding time for a newborn baby is once every three to four hours.

He said the period between feeding times should not exceed six hours.

“That would put the baby at risk of a fall in blood sugar. Glucose is needed to maintain consciousness and brain function. The infant would become agitated and lethargic,” Dr Corcoran said.

Pathological findings of brain changes associated with SIDS were not inconsistent with hypoglycaemia, the court heard.

“The delay in between feeding times would be a serious concern,” Dr Corcoran said.

Asked if a trace of methadone found in the baby’s system had any clinical significance, Dr Corcoran said: “No.”

The jury returned a narrative verdict setting out the facts of the case.

Coroner Dr Myra Cullinane expressed her sympathies to the mother, who is pregnant, and to the infant's wider family.