Infant Mortality Pt. II: A friend & a book about safe sleep help a local dad turn the page on loss

CINCINNATI - The news flashed one day around Cincinnati Children’s Hospital Medical Center : The chief resident, a new father, fell asleep on the couch at home--his infant Charlie on his chest-- and awakened to discover that the baby, just three weeks old, was dead.

Pediatric resident John Hutton felt sick to hear of the tragedy. Twenty-first century medicine and nutrition has tilted the overall odds for most babies. Campaigns to improve care, such as always putting a baby on its back for sleep, have saved more lives. But many mysteries remain, including the phenomenon of sudden unexplained infant death. And now, to know his friend Sam Hanke had endured such a loss?

When the two men met again, they embraced in sorrow. Then, life went on.

A foundation is born

After his chief residency, Hanke did a fellowship in pediatric cardiology. On what would have been Charlie’s first birthday, Hanke and his wife Maura created the Charlie’s Kids Foundation to offer education about sudden infant death, raising money with an annual golf tournament in Louisville.

In Ohio, 41 percent of infant deaths after the first month of life are sleep-related. The deaths fall into three roughly even categories:

  1. asphyxiations
  2. sudden infant death syndrome (SIDS)
  3. “undetermined”

A few months later, the Hankes had a second child, Owen. Coming home from the hospital, “I was amazed at the amount of information you get about sleep habits,” Sam Hanke said.

“But even though we, of all people, were very focused and interested on what they had to say about safe sleep, it was very sterile and not approachable. You could see how families would just read over it or not read it at all.”

In the fall of 2011, Hanke went to a conference on sudden infant deaths. A speaker’s presentation electrified him. Research now advocated for a broader “safe sleep” regimen, beyond simply putting a baby on its back for sleep.

No sleeping in the same bed with an infant, ever. No blankets or toys in a crib with an infant, ever.

The Hankes aimed the Charlie’s Kids Foundation to campaign for the new guidelines. But how to get that message across? Maura Hanke, a kindergarten teacher, proposed collecting children’s books, getting a sticker printed with the enhanced guidelines, putting the stickers on the books and giving them away.

For about a year, the foundation did just that. Then, when planning a giveaway with a safe-sleep nonprofit called Cribs for Kids , “The light bulb went off,” Sam Hanke said.

“We had a book here, too, to tell the story of safe sleep in an approachable way, a way people will want to come back to.”

Sam Hanke knew just the person to hear his idea.

Children’s lit and medicine

John Hutton was more than a decade older than his fellow residents at Children’s for a simple reason: He revived a bookstore.

In 2000, Hutton and his wife Sandra Gross were visiting a beloved children’s bookstore in Cincinnati and were dismayed to learn it was going out of business. Almost overnight, Hutton paused his career in medicine and with his wife became owner of the Blue Manatee bookstore in Oakley. Later, he started writing books, to promote early childhood literacy.

To persuade parents to move children younger than three away from TVs and computers and tablets and get them outside, Hutton wrote the “Baby Unplugged” series and published the books in a board-book format, for parents and children to read together.

When Hutton went back to medicine full time with a residency at Children’s, everyone knew about his literary detour--including Sam Hanke.

Though two years had passed since they had worked together, Hanke wrote to Hutton in late 2012 suggesting they meet to talk about a book idea.

“It was really a complete serendipity,” Hutton said. “What Sam wanted to do combined with what I wanted to do to convey health information was very much in sync.”

Hutton worked on a narrative framework and invited submissions from local artists to illustrate the book. He chose Leah Busch , who rendered the “dreamy, sleepytime” quality of Hutton’s words in soft, ethereal watercolors.

“I tried to convey it through the point of view of the baby,” Hutton said. “I wanted parents to want to read it, repeatedly, to the baby, and that they wouldn’t feel like they were being preached to.”

In the 84 words of “Sleep Baby Safe and Snug,” the infant tells Mom and Dad a story about good sleep practices:

I love my crib
Both day and night
No pillows or blankets,
Just me – just right.

The book is a hit

Hutton and Busch volunteered their work. With his publishing knowledge, Hutton went to Pint Sized Productions in Amherst, N.Y., the only domestic publisher of board books. The first run was 50,000; 30,000 copies immediately went to Cribs for Kids. Hanke and Hutton figured 20,000 books would last a year. They were gone in two months.

Then, not long after the birth of the Hankes’ third child, Annie, Sam Hanke

spoke at a June conference on infant death of his heartbreak, the creation of the foundation, his growing family, the book. Afterward, “Six or seven people came circling around me, 'Where can I get the book?’”

The State of Tennessee, which had just launched a new safe-sleep initiative, bought 86,000 copies to give away to families.

“It’s money well spent,” Hutton said, “Because you’re putting something into parents’ hands that will not only be valued and hopefully be read repeatedly, but also has a secondary benefit for having parents of babies to share that time together, and that has benefits down the road.”

Hanke, 34, and Hutton, 46, are staff physicians at Children’s. Sitting in the main hospital cafeteria, they flip through the board book together. Hutton points out a little inside joke: The artist, Busch, added the logo for Hutton’s “Baby Unplugged” series as a detail on one page.

Then Hanke runs a finger over the cover: Forever young in art, the cherubic face of a dozing baby with tousled brown curls: “And this,” he says, “is Charlie.” 

More about infant mortality in the region

About ten babies die in Hamilton County for every 1,000 births every year; the U.S. rate is a fraction more than six deaths for every 1,000 births. The rate among African-Americans in Hamilton County has for years been more than double the national average.

The rates in Northern Kentucky are also alarming:

  • Boone County: 4.8 deaths for every 1,000 births
  • Campbell County: 8.3 for every 1,000
  • Kenton County: 9.8 for every 1,000

Resources for pregnancy and birth:

Connect with WCPO Contributor Anne Saker on Twitter: @apsaker

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