One Is a Tragedy, Two Is Suspicious, and Three Is Murder

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What would you do if, out of the blue, your mother told you she had smothered her two-week-old son with a plastic bag before you were even born? What if the confession took place 35 years after the murder? It sounds like something out of a movie, but that is exactly what happened to Amy Brunka. And she went straight to the police.

Soon after she alerted law enforcement professionals, Amy learned that not only had her mother, Nancy Moronez, killed her older brother; she had also murdered two children she was babysitting – 6-month-old Brad Steege and 3-month-old Katie Kozniecki. And all three deaths were initially attributed to SIDS or Sudden Infant Death Syndrome. Ms. Moronez eventually confessed to all three murders; her explanation was that she couldn’t stand hearing the babies’ cry.

Nancy Moronez’s conviction seemed to support the adage in the title of this article, attributed to controversial British physician Dr. Roy Meadow. Meadow brought much-needed attention to medical child abuse but got into hot water after misusing statistics and advocating for the removal of children from parents later proven innocent. Recent research suggests that the causes of multiple infant deaths in a family are much more complicated than we initially thought and the line between deliberate harm and accident a lot blurrier.

Dead Tired and Risky Sleeping Practices

Nothing in this world prepared me for the sleep deprivation I experienced after the birth of my first child. I can still remember the middle-of-the-night desperation (and, at times, frustration) I felt as he cried and fussed and stayed awake and repeated. Time and again, I wondered; what was I doing wrong?

I would have given my life for him in a heartbeat, yet, on more than one occasion, I fell asleep with him laying on my chest. On a few others, my husband and I put him in between us because we were too tired to get up and put him in his bassinet. At the time, I had no idea that these things raised his risk of accidentally smothering 50 times. Had I known, I am almost 100 percent certain I would never have done either of these things. But I can also tell you that fatigue does not fuel good decision-making.

Apparently, I am not alone. A survey of more than 7000 new U.K. parents found that 46 percent have engaged in “unsafe sleep practices” in an exhaustion-driven attempt to get their babies to sleep longer, at times co-sleeping with their baby on their chest or on a sofa or armchair. A third of these parents acknowledged occasionally placing their infant on their front or side to sleep, knowing that putting them on their backs was safer but citing sleep deprivation and multiple failures to get their baby to sleep as often-mentioned reasons.

We’ve made progress. As parents have become better educated about safe sleep practices, the number of sudden infant deaths has gone down. In fact, the U.S. SIDS rate fell more than 40 percent from 1992 to 1998 — when there were about 2,800 cases — thanks to a national campaign urging parents to put their children to bed on their backs. Over the past 20 years, it’s dropped by half.

It is becoming increasingly clear that, in a substantial number of deaths, what was previously thought to be an as-yet-identified medical explanation for an infant’s death was actually accidental suffocation; a pillow or soft bedding covers an infant’s nose, a parent unintentionally rolls on top of the infant or the infant gets wedged between a mattress, etc. There also appear to be individual risk factors; if the infant was premature, had respiratory problems or a cold, or if someone smoked in the house. There may also be genetic risks; five years ago, doctors at Boston Children’s Hospital discovered lower levels of serotonin and a certain protein, along with other problems, in babies who died in their sleep.

Are Siblings of SIDs Babies More Likely to Die?

Recent research says yes. In fact, according to a longitudinal study released in June 2020, the siblings of infants who died suddenly and unexpectedly run 10 times the risk of dying in the same way. The big question is why.

Between 2000 and 2015, this study tracked U.K. families who had tragically experienced the unexpected death of an infant – and then experienced another one. Out of the 6608 families who lost one baby, only 26 families had a similar second tragedy (and, in three families, a third). The medical explanations given for the first deaths were SIDS in 11 cases; undetermined in eight cases; medical in three; accidental suffocation in two; and murder/probable murder in two.

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The causes of the second infant deaths were SIDS in 10 cases; unascertained in five; medical in four; accidental suffocation in six; and murder/probable murder in four. Among the SUDI siblings, 24 of the mothers smoked (which has been hypothetically linked to breathing problems in babies); unsafe sleeping occurred in 11 cases; 13 of the mothers had mental health issues before or after the birth; parenting concerns in 17 cases; and abuse or neglect in 10.

What do these findings mean? Not a lot. First of all, listing SIDs as a cause of death tells us nothing other than the baby’s death is still a mystery; it’s essentially the same as “undetermined” or “unascertained.” An autopsy was performed and there was no clear evidence of foul play and there was no clear evidence of a medical problem. At the end of the day, medical examiners could not explain 33 of the 55 deaths (60 percent).

But they were able to explain 40 percent. In seven of the 55 deaths (12.7 percent), a medical problem was found; in eight (15 percent), the infant was accidentally suffocated. In six of the deaths (10.9 percent), the medical examiner believed the baby was either probably or definitely murdered. Clearly, multiple infant deaths in a single-family do not always mean murder. And just as clearly, it sometimes does.

The Bottom Line

No one wants to accuse a grieving parent of murdering her child. And, the odds are, she didn’t. However, there are clear vulnerabilities in some families that can lead to a range of unfortunate outcomes – child abuse, accidental death, even murder. Finding ways to identify and support these families before tragedy strikes are critical. And, while multiple infant deaths in the same family should not automatically lead to the conclusion that homicide occurred, it should lead to a serious consideration of why.