Expert paediatrician Mike Starr tells infant inquest co-sleeping in filth was likely cause of death

This filthy fold-out bed likely caused the death of a baby boy as he co-slept with adults, an expert says – and authorities had been warned but did nothing.

A social worker for a not-for-profit agency attempted to check on the welfare of a teen mother – whose baby son later died – at least 15 times but had no legal right to enter the home, an inquest has heard.

Rachel Mayfield, who works for a rural charity that cannot be identified for legal reasons, told how her escalating concerns finally forced her to call in child protection authorities after almost four months.

The Coroners Court heard Ms Mayfield’s urgent notification was made a week before the death of the girl’s 11-week-old baby son, who died in squalid conditions in a South Australian town.

Police found the regional property strewn with rotten food, animal faeces and dirty nappes along with vomit-covered beds.

Ms Mayfield told Coroner David Whittle how during her only home visit with the mother, who cannot be identified due to secrecy orders, she noticed only a dirty floor.

But Ms Mayfield said her concerns mounted as the young mum delayed or failed to keep more appointments but was powerless to force entry as the program was voluntary.

Her concerns were further heightened on one visit to the girl’s home, when she was refused entry because the teenager was “a bit ashamed” about her “messy” house.

Unaware the girl was pregnant, Ms Mayfield observed rubbish in the yard, a full bin, an abandoned pram in the rain, car seats and dozens of drink containers strewn around.

One of only three times she met with the girl was at the girl’s mother’s house.

The bed where the baby died. Picture: SA Police

Ms Mayfield said after the Department for Child Protection ignored two emails from her about the case, she made an urgent notification to a child abuse hotline on November 20, 2018 – which she felt was her only option.

“I was concerned whereby a number of times she cancelled and not wanted us to visit,” she told the court under cross-examination from counsel assisting the Coroner Sally Giles.

“Also knowing she had small children worried me.”

The court has heard the urgent notification was closed because the department’s regional outpost did not have the “capacity” to intervene.

Ms Mayfield told the inquest that there now improved communication channels between the not-for-profit and the Child Protection and Human Services departments.

There were also frequent meeting which police and SA Health nurses attended, while she could phone local child protection workers directly.

Earlier, an expert paediatrician told the inquest that the baby’s death was preventable and likely occurred because he was co-sleeping on a filthy sofa bed.

Associate Professor Mike Starr, a paediatrician and infectious diseases expert, said it was his opinion the unsafe sleeping conditions, including the filthy state of the bedding and his stressed mother, led to the infant’s death.

The home is which the baby died. Picture: SA Police

The home where the baby boy died. Picture: SA Police

The home where the baby died. Picture: SA Police

He said other factors included that the infant’s mother smoked and that there were multiple people on the sofa at the time

Prof Starr said the mother being “under a lot of duress” at the time and “not coping” with her multiple children may have contributed to her son’s death.

However, he said he could not say the infant’s respiratory infection – found as a cause of death at autopsy – was a factor in him dying.

The inquest has previously heard there were 23 notifications made about the infant’s family, including the “immature” mother and older siblings before his death.

The inquest continues.