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Professionals can be deceived by intense grief of parents who smother their children

November 20, 2001

Parents who smother their children are capable of intense outpourings of grief over the loss of their child(ren), says a report in the Archives of Disease in Childhood. And this may deter doctors and other professionals from believing that murderous intent was involved, so exposing other children to risk, say the authors.

Some cases of deliberate suffocation have been misdiagnosed as sudden infant death syndrome (SIDS), but the lack of clear diagnostic criteria can make them very hard to diagnose, say the authors. Doctors and other professionals are often very unwilling to believe parents capable of such a deed.

But the authors illustrate their points with the verbatim account of a woman convicted of murdering three children by suffocation, two of them her own, and the attempted murder of two others which were initially diagnosed as SIDS.

The woman has been in therapy for several years, but has not had a major psychiatric illness. She gave her fully informed consent to the semi-structured interviews and their publication.

The woman suffocated her firstborn child, who had respiratory problems, because, she said, it gave her some control over what she feared was the inevitable death of her daughter. "That's why I killed her because I didn't want to lose hershe was my world, she was everything to me." She also described this murder as a "mercy killing."

She was utterly inconsolable, and had a breakdown. Then she became pregnant again. This second child cried a lot and was unable to replace the first, so the woman decided to kill her. "I knew exactly what I was doingI hated having to get up to feed herI thought, OK, I never got caught for [baby 1's] death, I don't want this childso I smothered her the same way as I did for [baby 1]."

The woman repeatedly looked for jobs in childcare and attempted to smother two children in her care, both of which were acts of revenge, she says. The third murder was of a 9 month old baby she was babysitting for a neighbour.

Serial child killing is rare, say the authors, and they do not suggest that every parent is a murderer or that health professionals should fail to empathise with genuine grief. But they say that, in this case, the woman's ability to engage trust and compassion would have helped her gain access to her later victims and may have allayed professionals' suspicions.

"Such empathy may contribute to natural resistance to serious consideration of evidence which indicates the parent may constitute a risk to their child."

British Medical Journal (BMJ)