LETHBRIDGE, Alta. — A mother accused in her toddler's death from bacterial meningitis says his face "just kept getting bluer and bluer'' as she desperately tried to get him to breathe the day he was rushed to hospital.
"He'd stopped breathing again and so I did the CPR again and I did a couple of chest compressions and he started to breathe. Nothing had come out and shortly after he stopped breathing again,'' a sobbing Collet Stephan testified in her own defence Thursday.
"The 911 operator was kind of directing me while doing the CPR with counting and so forth. I remember his face starting to turn blue.''
Toddler treated with natural remedies
Stephan, 35, and her husband, David, 32, are on trial accused of failing to provide the necessaries of life for 19-month-old Ezekiel in March 2012.
Ezekiel was sick for more than two weeks before he died in hospital. Court has heard how his parents gave him natural remedies, including smoothies with hot peppers and horseradish, because they thought he had croup.
Stephan told jurors that the first day of her son's illness was easily the worst. She said he had a fever and the wheezing and whistling noise was heartwrenching.
David and Collet Stephan arrive at court. (Photo: David Rossiter/CP)
She said her son's condition worsened after her husband noticed Ezekiel's breathing had changed. She put him on her lap and suddenly he stopped breathing.
"He choked and he stopped breathing for a few seconds. I hit him on the back. He started breathing again,'' she said as jurors and spectators wiped away tears.
"Then he just stopped breathing again and I put him on his back and put two breaths into his mouth forcing him to breath and put him on his side. He started coughing and he coughed up a bunch of mucus and phlegm.''
It was at that point they decided to take him to hospital and called an ambulance.
"I remember his face starting to turn blue.''
Ezekiel was airlifted to Alberta Children's Hospital in Calgary where his parents were told that there was little brain activity.
An interview with the RCMP while Ezekiel was on life support caused a great deal of worry, the mother admitted.
"I feared losing both our children. I was 20 weeks pregnant and having the fear of losing that child as well. It was a roller-coaster of emotions I was constantly going through,'' she testified.
"Our son was on life support and we were being told that someone felt we were neglectful. We were now being questioned on our parenting, too.''
Ezekiel was given fluids through an eyedropper
Court documents reveal just days before Ezekiel went to hospital his parents were giving him fluids through an eyedropper to keep him hydrated as he would not drink on his own. They also started him on an electrolyte and amino acid supplement, wrote Dr. Jenn D'Mello in an assessment.
His symptoms worsened.
"He would not eat or drink, was lethargic and they noticed his body to be very stiff. These symptoms persisted ... and he started being so stiff that his back was arched,'' D'Mello wrote.
Mother never saw physician
The assessment indicates Ezekiel's body was so stiff and sore that he couldn't be placed in a car seat.
Mello wrote on March 15, 2012, that Ezekiel "met criteria for brain death.''
A pathologist determined the boy died "as a result of bacterial meningitis and right pleural empyema (lung infection).''
D'Mello's report noted Collet Stephan never saw a physician during her pregnancy and did not have any blood tests or ultrasounds before Ezekiel's home birth.
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Your newborn should get this shot even before leaving the hospital, and receive another dose at one to two months and a third at six to 18 months. The vaccine protects against an incurable, liver-infecting virus, hepatitis B, which can be passed to a baby during childbirth if the mother is infected. This virus spreads through contact with blood or other body fluids (sharing toothbrushes and utensils can put you at risk). Soreness at the site of the shot, or a slight fever, is the most common side effect, according to Gabrielle Gold-von Simson, M.D., assistant professor of pediatrics at NYU Langone Medical Center in New York.
The DTaP vaccine protects against diphtheria (a germ that can form a gray or black film in the throat), tetanus (an infection that can cause muscle spasms so strong they can break bones), and pertussis (a highly contagious disease that causes a severe, uncontrollable cough, known as whooping cough). Five vaccine doses are given to children at two months, four months, six months, 15 to 18 months and four to six years. (And boosters at age 11 or 12 and then every 10 years.) DTaP may be combined with other vaccinations to reduce the number of shots needed. "Now, it's DTaP with hepatitis B and the polio vaccine. So, it's five in one," Dr. Gold-von Simson says.
This combo shot protects against three viruses: measles (which causes high fever and a body-wide rash); mumps (which causes face pain, swelling of the salivary glands, and sometimes scrotal swelling in boys); and rubella or German measles (which can cause birth defects if the infection occurs during pregnancy). The first shot is given at 12 to 15 months of age and once again between the ages of four and six. MMR is sometimes combined with the chickenpox vaccine into one shot (brand name ProQuad). "All these different preparations are designed to reduce the amount of shots the pediatrician has to give," says Dr. Gold-von Simson.
Chickenpox, a highly contagious rash that many people remember from childhood, is caused by the varicella virus. A varicella vaccine was first licensed in 1995 and now spares future generations this itchy misery. Chickenpox infections can be especially dangerous in adults who don't have immunity from the vaccine or haven't had it in childhood, and can also lead to shingles, an extremely painful blistering rash. The shot is given to children at 12 to 15 months and again between four and six years. The vaccine can cause soreness at the site of the shot, fever, and, in some cases, a mild rash.
"Haemophilus influenza type b is the bacterium that causes meningitis," says Dr. Gold-von Simson. Meningitis, an inflammation of the membranes surrounding the brain and spinal cord, is particularly dangerous for kids under the age of five. Hib vaccines are generally given at two, four, six, and 12 to 15 months of age. Depending on the vaccine used, the six-month shot may not be needed. Fever, swelling, and redness at the site of the shot are potential side effects.
Polio vaccine is "such a success," says Dr. Gold-von Simson. "Because of the vaccine, there are no more cases (of polio)." There are no more in the United States that is. The virus hasn't been eradicated worldwide, so kids still get the IPV, or inactivated polio vaccine, which is a shot containing killed virus. Polio is bad news, and can cause paralysis and even death. Children are given the IPV at two months, four months, between six to 18 months, and then again between the ages of four and six years.
This vaccine, known as PCV13 (brand name Prevnar), protects against 13 types of Streptococcus pneumoniae, which are bacteria that can cause all sorts of mayhem, including meningitis, pneumonia, ear infections, blood infections, and even death. A total of four shots are given to kids (at two, four, six, and 12 to 15 months of age) to protect them against the germs, known collectively as pneumococcal bacteria. The most common side effects of the vaccine include drowsiness, swelling at the site of the shot, mild fever, and irritability.
Flu vaccinations are given each year starting in the fall. The Centers for Disease Control and Prevention recommends them for kids ages six months or older, although they aren't required for school attendance. (Connecticut and New Jersey require the vaccine for attending child-care centers and preschool.) Common side effects from the vaccine include soreness, redness, or swelling at the site of the shot. Fever and aches may occur too. "If you have an egg allergy, you shouldn't have the influenza vaccine," says Dr. Gold-von Simson.
The rotavirus vaccine (RV) (brand names RotaTeq, Rotarix) is given to children at two and four months of age. (RotaTeq is also given at six months.) The vaccine protects against a virus that is the most common cause of severe diarrhea and vomiting in young kids worldwide. About 55,000 children in the U.S. were hospitalized each year due to rotavirus before the vaccine was licensed in 2006. It is not required for school attendance. The vaccine is in liquid form and given by mouth to babies. It may make them a bit more irritable and can also cause mild diarrhea or vomiting.
Kids can catch hepatitis A from sharing food or drinks or by putting contaminated food or objects in their mouths. It's a viral infection that affects the liver, and can cause a number of symptoms, including fever, tiredness, jaundice, and loss of appetite. Children ages 12 through 23 months generally get two doses of the Hep A vaccine, with a minimum interval of six months between shots. Some states require the vaccine for school attendance. Soreness where the shot was given, headache, and loss of appetite are the most common side effects of the vaccine.
This vaccine, known as MCV4 (brand name Menactra), protects against meningococcal bacteria, which can infect the membranes surrounding the brain and spinal cord. MCV4 is recommended for kids at 11 or 12 years of age, and anyone between ages two and 55 who is at increased risk of infection (people with certain health conditions, military recruits). Teens starting college should be vaccinated with MCV4 before going to school if they didn't previously get the shot. (Freshman living in dorms are at increased risk of infection.) A little pain at the site of the shot is the most common side effect.
Human papillomavirus (HPV) vaccine (brand names Gardasil, Cervarix) is given in three doses over a six-month period, and is approved for girls between ages nine and 26. While there are over a hundred types of HPV, this vaccine protects against two sexually transmitted types that are the most common causes of cervical cancer. Gardasil also protects against two types that cause genital warts and is approved for boys between nine and 26 as well. The vaccine works only if given before an infection, so doctors recommend it for kids well before they could become sexually active. Although most states don't require HPV vaccination, many are considering mandating it for preteen girls.