Illustration by Eleanor Doughty

When Your Baby Dies in a Home Daycare, Who's to Blame?

When Kathryn Martin first placed her three-month-old daughter, Kellie Rynn, in a home daycare center, she thought she had no reason to fear. A month later, Kellie Rynn suffocated in her sleep. Though the coroner's report lists Kellie Rynn's death as an...

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Feb 6 2017, 4:20pm

Illustration by Eleanor Doughty

Kellie Rynn Martin was three months old when she suffocated at a home daycare center in Greenville County, South Carolina, in 2014. An EMT arrived a swift two minutes after her caretaker called 911, but it was too late for Kellie Rynn, who had already suffered from fatal anoxic brain damage. On her coroner's report, her manner of death is listed as "suffocation by bedding," an "accident." There were marks on her body where her naptime blankets would have been.

Kellie Rynn's mother, Kathryn Martin, had suffered a miscarriage a year before giving birth to Kellie. "Right when she was being born," Martin recalled, "I thought the worst was over: She's here. She's healthy. You don't think about how children are still vulnerable to other people."

Like countless other infants, Kellie Rynn died because her daycare facility neglected to follow basic safety protocols for minding babies. The day Kellie Rynn suffocated, 22 other children were being looked after by her daycare provider—over a dozen more than the legal limit for South Carolina. Martin suspects that Kellie Rynn was placed in a basinet with another infant or too many blankets and left unwatched, well-known mistakes that can lead to suffocation.

Watch now: Maternity Leave: How America Is Failing Its Mothers

On any day of the workweek, nearly seven million preschoolers are entrusted to organized care facilities, five million of them in daycare. For the 1.7 million working mothers of children under one year old, entrusting their child to a stranger for eight hours every weekday is a petrifying but necessary evil: The United States and Papua New Guinea are the only two countries in the world that do not guarantee paid maternity leave. In fact, only 12 percent of the workforce in the US has access to paid parental leave. Daycare wait lists are notoriously long, forcing parents to place their children in home daycare centers, which, according to parents and experts interviewed, are under-scrutinized and barely regulated. And when an infant dies at a home daycare center due to neglect, justice for parents can be difficult, if not impossible, to achieve.

Like thousands of parents across the country, Martin left her infant daughter in a home daycare because she needed to return to work as soon as possible after giving birth. Martin had just six weeks' paid maternity leave; in South Carolina, where she and her husband live, there is no law requiring employers to offer parental leave. If she stayed home to care for her daughter, Martin risked losing her job and the family's health insurance.

When it was time for her to return to work, Martin realized that more structured local childcare centers, run out of churches and schools, were full. One even had a two-year waiting list.

Martin found an in-home daycare center, a middle-class suburban home situated behind a smattering of trees, run by a woman named Pamela Wood. The Saturday after Kellie Rynn's first Christmas, Martin and her husband toured Wood's home and found it to be clean and Wood to be competent and kind. Martin's friends, who had entrusted their children to Wood for seven years, had vetted the provider.

Right when she was being born, I thought the worst was over: She's here. She's healthy.

One month after Martin first left Kellie Rynn at daycare, she received an urgent call from Wood instructing her to go to the hospital. For thirty horrifying minutes, Martin couldn't find Kellie Rynn in the hospital's computer system—because she had been pronounced dead in the ambulance, according to the coroner's report.

After forensics and the police arrived to Wood's house with a search warrant, other parents came to pick up their children. Wood was anxious to return to her house, Martin recalled, to care for the other five children she was allowed charge of, in accordance with South Carolina's home daycare regulations.

"A parent arrived whose child was not part of the five," Martin explained. "The police did an emergency search of the house and found 14 other children in the basement with [Wood's] daughter. They had been there for two hours. The room was 85 degrees." Police investigation documents corroborate this.

"They were playing the quiet game," Martin added.

In 2014, similar circumstances lead to the death of Tabatha Noble's son Hunter, who also suffocated at a home daycare when he was two months old. "He was very healthy. Very happy," Noble recalled. "I was in labor for 13 hours. That was all pushing, so that's bad hours!"

Initially, Noble and her husband planned for her mother-in-law to take care of Hunter when they had to return to work at the pool service and repair company they run together. In Nevada, where Noble lives, state laws do not require employers to offer parental leave. They later decided to place Hunter in daycare; one in particular, Shining Stars Family Daycare, seemed like a good environment. After she and her husband ran background checks on the owner, they decided to leave their son there.

The police did an emergency search of the house and found 14 other children in the basement... They had been there for two hours.

On the first day of daycare, Noble was a wreck. She asked to visit her son during lunch, but the provider allegedly said it was a bad idea—the children would be napping. In retrospect, Noble says, that should have been a red flag.

The following Tuesday at 3 PM, Noble received a call saying that Hunter wasn't breathing and was in an ambulance to the hospital.

"When I got to the room, they just stopped [performing CPR]. I didn't understand why they were stopping, why they weren't trying to revive him," Noble said. "They said Hunter was gone before he was even in the ambulance."

After the police questioned the provider several times, Noble says, the provider finally admitted that she had placed Hunter on his stomach, a dangerous position for infants who can't hold up their heads, and left him for an extended period of time. Hunter's face was bruised from banging his head on the bottom of the playpen until he suffocated. Noble insists she told the provider that Hunter was not ready for "tummy time." (The provider could not be reached for comment and her lawyer did not respond to questions, but after Hunter's death, she obtained a temporary protective order against Noble's husband.)

"She made the promise to watch our son and care for him as if he was her own. But really, he was just money to her," Noble said. Eventually, it came out that the provider was unlicensed. Hunter's cause of death was listed as accidental suffocation.

Kellie Rynn. Photo courtesy of Kathyrn Martin.

Dr. Rachel Moon, the University of Virginia's Division Head of General Pediatrics, studies infant deaths, particularly sleep-related fatalities. She noted that 3,500 infants a year die from sudden and unexpected infant death syndrome (SUIDS), the technical term for abrupt infant fatalities that typically occur during sleep. It's the leading cause of death for infants under one year old. In November, a breakthrough study linked SUIDS to lower levels of a protein that would usually signal an infant to roll over in bed and breathe. Moon educates parents about safe sleep practices, but says that it isn't enough.

According to Moon, daycare providers who don't go through the proper legal channels to register can be woefully uninformed about safe sleep practices. Unregistered daycare providers have few opportunities for education.

"Babies are more likely to die at home daycare centers than in daycare centers," Moon said, citing anecdotal evidence. Data on how many infants die at home daycare centers does not exist—most death certificates list the place of death as the hospital—but the American Academy of Pediatrics notes that one in five cases of SUIDS occurs when an infant is not in their parents' care.

"A lot of home daycare centers aren't regulated," Moon added. "They don't register. They don't get informational material about safe sleeping."

Some children just die, and it isn't always somebody's fault.

Noble and Martin say that their children would have lived if their daycare providers were more mindful of safe sleep practices such as laying them on their backs, not on their stomachs (which makes them 18 times more likely to die from SUIDS). Placing infants in cribs or bassinets with soft bedding is also known to impair their ability to breathe. Regular monitoring, however, is the most important guard against SUIDs—and Noble alleges that her provider did not check on Hunter for over an hour, 45 minutes later than she should have.

Regulation for home daycare centers differs state-by-state. Some states have no regulations. Many require background checks and surprise inspections, according to the National Resource Center for Health and Safety in Child Care and Early Education. Group sizes, insurance, sanitation, food preparation, and fire safety are some of what licensing can cover. Websites cataloging the minimum standards of operation are careful to note that a license to operate a daycare facility is not an indicator of quality care.

In the summer of 2016, three infants died in separate Connecticut daycare facilities within the span of four months. Two of those facilities were unlicensed and caring for over eight infants.

Noble found out after Hunter's death that her home daycare provider was not registered. And, while the facility Martin placed her child in was licensed, it violated the terms of its registration by accommodating more many times more children than the legal limit. Martin's lawyers persuaded her not to pursue the provider in court—Wood instead agreed to 18 months house arrest and 20 hours of community service. She pled guilty to one count of child neglect, one count obstruction of justice, and one count of unlawful running of a childcare center.

"Some children just die, and it isn't always somebody's fault," Wood's lawyer said, according to the Greenville Online. Martin disagrees.

Do we value our babies' lives? Do we value moms and their mental health? Do we value working moms?

Since 2014, Martin has been speaking to the Senate and House, urging for changes in childcare. In her state, South Carolina, the DSS would visit a licensed center without prior warning two times every year, though in-house facilities would never be inspected unless there was a complaint. Martin helped to pass a law in July 2014 that would require one unannounced visit for in-home providers, and noted that over 60 in-home centers have been shut down as a result. She later started the Kellie Rynn Academy to help provide daycare scholarships to Greenville families in need.

Ali Dodd, whom Broadly interviewed earlier this year, started the Shepard's Watch foundation to improve daycare safety in her home state of Oklahoma after her months-old son, Shepard, died in a provider's care. According to Dodd, Shepard was placed in a car seat to sleep and left alone for two hours; while he was unattended, he slipped down and suffocated, unable to lift his head. The nonprofit is advocating for improved sleep safety and education. (Dodd says Shepard "was forced" into daycare after she and her husband ran out of saved money and needed to return to work.)

"I was determined not to let this happen at another facility," Dodd said. The day before we spoke, two bills she'd worked on were signed by her governor. One requires all DHS-licensed facilities to put infants on safe sleeping surfaces. The other requires that parents placing their children in home daycare must receive and sign a notification stating that they know the facility is uninsured.

"Back then, the provider wouldn't even have to tell them," she said. "We were being irresponsible with our more precious lives. It was unacceptable."

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Dodd, Noble, and Martin don't think that there's a single fix to prevent SUIDS at home daycare facilities. "I wish it was a one-faceted issue, because then it'd be fixed," Dodd said. "It's not. Do we value our babies' lives? Do we value moms and their mental health? Do we value working moms? Finally, do we value access to healthcare?"

Noble added, "When you suffer loss like this, it's hard to determine where to direct your emotions or anger. First and foremost, I blame the caregiver for not being truthful. My son was really just money to her. I also blame the fact that there are no laws in place regulating these things." Noble is optimistic about Ivanka Trump's proposal to guarantee six weeks paid maternity leave for working mothers, which President Trump's website notes under its "Child Care" section.

Noble gave birth to a son named Grayson one year, to the day, after her son Hunter's death. She says they look identical—her husband even jokes that Grayson is Hunter's reincarnation. Noble, however, is careful not to raise Grayson in his brother's shadow. She and her husband packed away all of Hunter's belongings, left untouched in his room, three months before Grayson's birth. To help take care of their new son, Noble's mother-in-law moved in with the family. Grayson will never see the inside of a home daycare center.