Nanny probably gave antihistamine to baby who died to 'sedate' him

A baby died after being given an antihistamine by a nanny who probably wanted to "sedate" him, a coroner has ruled.

An inquest found failures by the Metropolitan Police when investigating what happened to the eight-week-old baby boy, including a failure to look in bathroom cabinets for medication or seize feeding bottles, meaning "forensic opportunities were missed".

Professor Fiona Wilcox, coroner for Inner West London, said in her prevention of future deaths report that she was also concerned there is "no national regulation system for nannies" and that the person who looked after the infant is still working as a nanny.

She sent her findings to Metropolitan Police Commissioner, Sir Mark Rowley, nanny organisations, the National Crime Agency and the College of Policing.

She said the baby had been found unresponsive in a bassinet at around 6.15am by the night nanny.

Resuscitation was attempted and an ambulance called, but the baby was pronounced dead at 7am.

The antihistamine chlorpheniramine was present in the baby's blood at the time of death, with the coroner saying "this was probably administered to (the baby) by the night nanny".

Recording an open verdict, Prof Wilcox added: "The court was satisfied that the night nanny had administered the chlorpheniramine (trade name usually Piriton) to the baby.

"The baby had been described as unsettled and fussy and a baby who woke frequently in the night.

"The chlorpheniramine was probably administered to sedate the baby to sleep.

"Expert opinion accepted by the court was that this drug could possibly have caused or contributed to the baby's death, but it could not be found that it probably did."
The coroner said toxicology findings only became apparent when the post-mortem report was sent to the court, police and the family.

"Evidence was heard that chlorpheniramine causes sedative effects and has been associated with child deaths and should not be administered to a baby this age except on medical advice to treat conditions such as allergy or itch associated with chicken pox infection.

It should not be administered to sedate a child."
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On the day of the death, police attended and "made an initial assessment", the report said.

"The night nanny stated that they had fed (the baby) twice that night.

"This (police) examination did not appear to consider that (the nanny) may have been administered a drug.

"The examination did not include examination of bathroom cabinets for medication ...

seizing feeding bottles nor examination of property of the night nanny, nor opening any cupboard doors or drawers in the room in which (the baby) had been found, nor the room next door.

"As such, forensic opportunities were missed that may have been able to establish that chlorpheniramine had been administered to the baby by the night nanny to the criminal standard.

"The night nanny was not arrested and interviewed nor their property searched until October 2024.

By then of course all forensic opportunities had been lost."
Prof Wilcox said the police accepted during the inquest that they have responsibility to exclude suspicious circumstances.

The night nanny told the inquest she regularly attended training and was still working as a nanny and registered with two agencies.

She was also concerned that feeding bottles and equipment are not routinely seized pending toxicology results, and that "insufficient consideration is given the potential role of poisoning in such deaths by the police".

Prof Wilcox suggested police training and guidelines may need to be updated and "that nannies should be specifically trained not to administer Piriton or other chlorpheniramine-containing substances to a child except on medical advice and with full knowledge and agreement of parents."
She also expressed concern "that a person whom the court found administered chlorpheniramine illicitly to a child and that administration possibly contributed to that child's death is still working as a nanny".

Furthermore, warning information on products containing chlorpheniramine, such as Piriton, may also need to be updated, she said.

The medical cause of death of the baby was listed as sudden unexpected death in infancy - unexplained.

"When we continue to see concerns raised at this level, it underlines that this is not about one isolated incident - it's a systemic issue.

"Parents are placing trust in individuals using professional titles, often assuming a level of training and oversight that simply isn't required.

That has to change.

"We have been calling for mandatory registration, clear standards, and proper safeguarding checks for some time.

This report reinforces just how urgent that need now is."
Earlier this month a different coroner criticised the "misleading" use of the title "maternity nurse" after the death of baby Madison Bruce Smith.

A maternity nurse - who had no medical qualifications other than basic first aid - employed by the family had said four-month-old Madison should be positioned to sleep on his front to help sleep, despite national guidance that babies should always be placed on their backs.

The Met Police and the manufacturers of Piriton have been contacted for comment.