HARRISBURG — Two sets of Pennsylvania parents face felony charges after police say their infants died in unsafe sleep positions.
While experts and family advocates say young babies should sleep on their backs without anything in the crib, simply failing to follow the recommendations shouldn’t amount to a crime.
In both cases, brought in the past six months, law enforcement say the parents knowingly put their children at risk. Parents from Lebanon County are accused of putting their son to sleep on his stomach with a pillow in the crib (the mother told PennLive she put her son on his back, but that he had learned how to roll over). A mother from Luzerne County, meanwhile, was charged after police say she let her daughter sleep face down in a U-shaped pillow.
Law enforcement argued in charging documents that the parents should have known better. They cited signed acknowledgements created as part of a 2010 law the state legislature passed to educate parents about Sudden Infant Death Syndrome (SIDS). The law requires hospitals, birthing centers, and health care practitioners to provide educational materials, then ask the parents to certify they received them.
The statement is voluntary, and there is a box noting if parents refused to sign.
The lawmaker who championed the measure, former state Rep. Lawrence Curry (D., Montgomery), died in 2018. News reports from the time say the bill was written with input from two safe-sleep experts with Cribs for Kids, a Pittsburgh-based organization that seeks to prevent sleep-related deaths.
Neither expert was available to comment, but other people dedicated to educating parents and preventing SIDS deaths oppose bringing criminal charges against grieving parents and note that there is no law against stomach sleeping.
“To charge them criminally is a crime, because they have already suffered the worst loss,” said Nancy Maruyama, the executive director of Sudden Infant Death Services of Illinois, a nonprofit organization that educates the public about safe-sleep practices and provides support to families who have experienced the loss of an infant.
“There’s nothing else you could have done to me that would have caused any more pain than the payment I had,” said Maruyama, who lost her son in 1985. “My heart’s broken.”
Safe-sleep experts stressed that these situations are not as cut and dried as a parent should have known better.
They talked about potential contributing factors like the differences in time spent educating parents in the hospital, if someone a parent trusts tells them stomach sleeping is OK, and even images parents see online that show an infant sleeping on their stomach.
The law “says that families have to receive that education, but it doesn’t say how that education is delivered, and it doesn’t state how families’ understanding or learning is evaluated,” said Devon George, chief programs officer at Cribs for Kids. (George was not involved in the drafting of the law.)
In Lebanon County, Gina and David Strause were charged in May with involuntary manslaughter, recklessly endangering another person, and endangering the welfare of children after the death of their son Gavin. Gina Strause told PennLive she put her son on his back, but that he was able to roll over. She told the outlet she did not recall taking home safe-sleep instructions.
In Luzerne County, Natalee Rasmus was charged in December with third-degree murder, involuntary manslaughter, and endangering the welfare of children after her 1-month-old daughter, Avaya, died.
Officers say they found the baby face down in a bassinet propped up on a U-shaped pillow linked to other infant deaths.
“Yeah, she wouldn’t sleep, she’ll just scream, so she has to be like propped up,” Rasmus, who was 17 at the time her daughter was born, told the investigating officer, according to the documents.
Rasmus’ public defender did not respond to requests for comment. Neither did the district attorneys in Lebanon and Luzerne Counties.
Maruyama said it’s her job to use evidence-based, peer-reviewed information to educate people with a baby about safe-sleep recommendations.
“But, you know, sometimes they’re just so tired and they just want their child to sleep, and they know if they put them on their tummy, they’ll sleep,” she said.
In 1992, the American Academy of Pediatrics first recommended that infants sleep on their backs or sides. Four years later, the organization changed the recommendation to only back sleeping. Since then, SIDS rates have plummeted, although sleep-related deaths remain a leading cause of infant mortality.
That’s what prompted the 2010 law, which directed the Pennsylvania Department of Health to create and recommend safe-sleep materials.
The “information provided to parents must include risk factors associated with sudden unexpected infant death (SUID) and advise them about safe sleep practices,” a department spokesperson told Spotlight PA.
The agency provides a brochure that complies with Act 73 in hard copy and electronic format. That brochure is two pages long and repeats recommendations from the American Academy of Pediatrics that babies should not sleep with others and should sleep on their backs in an uncluttered crib.
The state also funds PA Safe Sleep, which provides birthing hospitals with services including patient education information and expert training, and safe-sleep education at the county level through children and youth agencies.
George said it’s important to question how hospitals are delivering information and evaluating what parents are learning.
But the most important question about these situations, she said, should be: “How are we helping families? How are we supporting families?”
Of the 343 infant deaths reported in Pennsylvania in 2022 (the most recent year data is available), unsafe sleep factors were present in 68 cases, according to a state report.
While education is crucial to drop the rates of these deaths, it is not enough on its own, said Michael Goodstein, a neonatologist at WellSpan hospital in York County. He is also the director of the county Cribs for Kids program and a member of an American Academy of Pediatrics subcommittee on sudden unexpected infant deaths.
A parent who watches a video with their doctor and gets all their questions on safe sleep answered versus the parent who gets a handout will have a different level of understanding on the topic, Goodstein said.
Like all experts who spoke to Spotlight PA, Goodstein said this is a complex issue that needs more attention, more awareness, and more research.
“It’s really important to follow the safe-sleep recommendations,” Goodstein said. “I’m not going to say it’s easy to do. Babies get fussy and parents are sleep deprived, and at some point, they sometimes do things that might help the baby get back to sleep faster, so that they get some sleep, but in the end, is not a safe thing to do.”
Rare charges
It’s extremely rare for parents to be charged with a crime after their infants die sleeping on their stomachs, said Daniel Nevins, who has over 20 years of experience as a criminal defense attorney.
Nevins said he couldn’t name another case off the top of his head with similar facts.
Spotlight PA identified a handful of criminal cases nationwide related to the deaths of infants sleeping in Boppy pillows, like the one police say Rasmus used. Charges have also been brought against parents who slept in the same bed as their child.
In the recent Pennsylvania cases, Nevins said the burden of proof for prosecutors is high.
To secure a conviction for involuntary manslaughter — which is punishable by up to 10 years in prison — prosecutors will have to prove that the parents acted dangerously or recklessly and that they should have known better.
For third-degree murder — which can be punished with up to 40 years in prison — prosecutors do not have to prove that the death was intentional but do have to demonstrate malice.
“The commonwealth had better think long and hard about whether or not they have enough evidence to pursue these types of charges,” Nevins said.