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How Two Baby Deaths Led to a Misguided SIDS Theory

New York cases caused a doctor to conclude the syndrome was the result of sleep apnea. What he didn't see was a mother who tried to get away with murder.

October 20, 1997

In "The Death of Innocents," just published by Bantam Books, Richard Firstman and Jamie Talan reveal how the undetected murders of five children in one family in the late 1960s and early 1970s triggered a theory about sudden infant death syndrome (SIDS) that has misled the medical world for 25 years.

The book tells the story of Waneta Hoyt, an upstate New York woman convicted in 1995 of murdering her five children, one after another between 1965 and 1971. The book also tells the parallel story of how Dr. Alfred Steinschneider, who went on to become a world-renowned SIDS researcher, used their case as the basis of his theory that SIDS was the result of prolonged sleep apnea, that it could be predicted and prevented with the use of a new device called a home apnea monitor, and that it could run in families.

After studying the last two Hoyt babies, Molly and Noah, in his lab at Upstate Medical Center in Syracuse, N.Y., in 1970 and 1971, Steinschneider presented their deaths--and lives--as evidence of his theory in a landmark paper published in October 1972 in the prestigious journal Pediatrics. The theory triggered the multimillion-dollar industry of home infant monitors. There are an estimated 40,000 monitors in use today, despite the lack of any evidence that they can prevent SIDS. In a commentary about "The Death of Innocents" in the October issue of Pediatrics--the 25th anniversary of Steinschneider's paper--the journal's editor, Dr. Jerold Lucey, writes, "We should never have published this paper."

The following excerpt from the book describes the last days and hours of the life of 2-month-old Molly Hoyt in June 1970. While Steinschneider believed Molly--the fourth child of Waneta and Tim Hoyt--had shown a pattern of prolonged sleep apnea, the nurses who cared for her around the clock had become much more concerned about how uninterested her mother seemed to be in her--and what this might mean about the three children who had died before. Molly had twice been sent home with an apnea monitor--the first baby in the world to sleep with one at home--only to be returned to the hospital the next day by Waneta, who said the baby had stopped breathing. The nurses, increasingly frustrated at Steinschneider's refusal to heed their suspicions, began talking about their fears of what might happen the next time Molly was sent home with her mother.

*

Though she was by any standard measure a normal, healthy baby, Molly Hoyt had by the first of June spent 51 of her 75 days of life in the hospital. Her psychological well-being was another matter. The Hoyts' visits had trailed off to once every three or four days, and it seemed to the research clinic's head nurse, Thelma Schneider, that the baby was virtually motherless. In recent days, Thelma had been paying close attention to what she felt was a continuing divergence between Molly's physical condition and her emotional and mental development.

She ate well, slept well, and gained weight on schedule. But her rosy cast was giving way to a certain dullness, and Thelma began entering these observations into the record. "Child has little or no affect," she wrote on Tuesday morning, June 2. ". . . Does not smile at people."

Forty-eight hours later, on Thursday, June 4, Steinschneider scheduled Molly for her third discharge. By now, the nurses were speaking more openly about their suspicions. "I just know something's going to happen," Corrine Dower said to Thelma. "One of these times she's going to do it." Corrine was scornful of Steinschneider. "If he had any brains at all he would have seen that she didn't want the baby," she would say years later. "You can tell in the grocery store if a person cares about their child. We were just disgusted with Steinschneider."

For Thelma, talking to Steinschneider about Molly Hoyt had become nearly routine--and routinely fruitless. "Don't you want to know what's going on in that home?" she asked suggestively one day. She hoped he would pick up her signals and start broadening his perspective. The baby's chest was now red and raw from the monitor leads--was this necessary? Of course it was necessary, Steinschneider said--the baby has apnea. "He so believed in what he was doing," Thelma later remembered with high exasperation. "To him this was just a bunch of opinion from nurses."

*

On the morning the baby was to be sent home again, Thelma tried once more. Steinschneider listened, said nothing. Thelma found it unbearably frustrating that Molly's life hung in the balance, and only Steinschneider had the power to do something to confirm or refute the suspicion. In 1970, that was the immutable protocol of the hospital.

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