Fentanyl’s littlest victims: Dozens of babies, toddlers die in Missouri and Kansas

The boy’s tiny lifeless body lay on a bed last year inside a home along The Paseo.

When Kansas City police officers found 2-year-old Cillian Miller in August 2022, he was wearing only a green T-shirt and was naked from the waist down. Most of his body was covered in a blanket except his feet, which were already discolored, court records show.

Strewn throughout the home were new and used syringes, glass pipes and “multiple strips of foil with apparent burnt residue.” One pipe was left underneath a partially eaten McDonald’s cheeseburger on the dining room table. And somewhere inside that home, the child came across fentanyl.

Tests would later show the little boy was yet another victim of the drug ravaging the nation and taking hundreds of lives in the Kansas City area.

In KC, and across both Missouri and Kansas, dozens of little children have died from the illicit drug in the past three years, The Star has found in an ongoing investigation into the toll fentanyl has taken on our community. This report on our youngest victims launches an extensive project that will include community outreach and stories about the broader impact of fentanyl on the Kansas City area and the challenges of policing the problem.

Unlike other drug crises, including crack, these children aren’t suffering from debilitating addictions because their parents were using; they are dying of actual fentanyl overdoses. The babies and toddlers — ages 4 and under — have come across the synthetic opioid and its residue in their homes, inside hotel rooms and even at a city park.

Their deaths have largely gone unnoticed, ending up as statistics inside annual state reports on child deaths or in records kept by county medical examiners. Most of the attention on fentanyl has focused on teens or young adults and the awareness that “one pill can kill.”

But last year alone, seven children in Jackson County ages 2 and under died from fentanyl — three of them within one week last spring, records obtained by The Star revealed. Across the state line three years ago, another toddler, age 2, died in Johnson County and a 9-month old died in Leavenworth County of fentanyl intoxication.

“It’s grabbing hold of our children now,” said Frank Tennant, chief of Missouri’s State Technical Assistance Team, a specialized law enforcement agency that investigates crimes against children and is under the Department of Social Services. “Fentanyl scares me, and not a lot scares me.

“It’s straight from hell as far as I’m concerned.”

In Jackson County, one child who died of fentanyl intoxication last year was a 10-month-old baby. The remaining six were toddlers ages 1 to 2.

Counterfeit pills — made to look like prescription medications, but that actually contain fentanyl — have been permeating the illicit drug market and are of increasing concern.

“Toddlers put everything in their mouths,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse. “So a pill that has fentanyl could have been a cause for them to die of an overdose because a pill can kill an adult.

“It’s very frightening and we’re seeing it across all ages and all demographics. And the individuals in the past that were not at risk for overdosing from fentanyl because they were not taking drugs or anything are now actually vulnerable.”

Much of the time “people are unaware that a child has gotten into something,” said Dr. Adam Algren, a medical toxicologist at Children’s Mercy. “Nobody sees them get into something. And then, you know, people think that they’re sleeping or taking a nap.

“And it’s not until they don’t wake up that people start to realize that there’s a problem. At that point, it’s often too late.”

No way to tell

After a child dies, authorities are still unable to determine how the fentanyl got into the body.

“Once it gets in the system, in the blood, it looks the same if they snorted it or ingested it,” said Dr. Lindsey Haldiman, Jackson County’s chief medical examiner. “There’s just no way to tell.”

Symptoms of an opioid overdose “are going to look very similar” in young children and adults, Algren said.

“You’re going to see people kind of become unconscious, you’re going to see that the breathing is slowed and disorganized,” Algren said. “And then you’re going to see that they’ve got very small pupils. ... That triad of symptoms would make me think of an opioid overdose and specifically, fentanyl a lot of times.”

Statewide, the number of young children dying from fentanyl has been “skyrocketing since about 2020,” said Dr. Terra Frazier, the chair of Missouri’s Child Fatality Review Panel. “It’s very dire ... and (numbers are) going to go up.”

In 2021, 10 children under 5 years old died from fentanyl poisoning in Missouri. By 2022, preliminary reports show that had doubled to 20, according to numbers provided by DSS.

And in 2023, “we think it’ll be higher,” said Frazier, a child abuse pediatrician at Children’s Mercy. “We still have a lot of missing data, so we can’t say for sure. But we expect that with the trends we’re seeing that it will be above 20.”

In Kansas, the State Child Death Review Board reported that no children died of fentanyl in 2017 through 2019, 11 died in 2020 and nine died in 2021. There was no indication of what specific ages that included.

Child welfare officials and advocates in both states say they are just beginning to study the devastating effect of fentanyl and its impact on small children and their families.

“Every single one of these babies and toddlers are very real people that had cute little smiles and curly hair, and their own little personalities and their own beauty inside of them,” said Emily van Schenkhof, executive director of the Children’s Trust Fund of Missouri, the state’s foundation for child abuse prevention. “They’re real.

“And I think sometimes you look at data and you (only) look at how many deaths there were. (But) those are very real children that died.”

Across the nation, police are investigating a spiraling number of fentanyl-related deaths of young children. Just last month, a 1-year-old boy died after being exposed to fentanyl inside a New York City day care. Three other children, from 8 months to 2 years old, became seriously ill and were revived with naloxone, often referred to by its brand name Narcan, which reverses the effects of fentanyl. Police said tests confirmed that fentanyl was present in the three survivors, news reports said.

Authorities urge every household to have a supply of Narcan on hand. The medication, a nasal spray, can be given safely to people of all ages, from infants to older adults, according to the Centers for Disease Control and Prevention.

In one high-profile St. Louis County case, three people were charged last November in the death of a toddler who ingested fentanyl in a residence.

The three suspects told police they knew the child had ingested fentanyl on Nov. 10 but did not attempt to get her medical attention. The St. Louis Post-Dispatch said the case was at least the seventh to be filed in the area in 2022 that involved children becoming ill from fentanyl. Four of those cases resulted in deaths.

A report published online in May in JAMA Pediatrics said children’s deaths from fentanyl began to increase nationwide in recent years.

“A surge that began in 2018 has led to a nearly 3-fold increase in deaths among older adolescents and a nearly 6-fold increase among children younger than 5 years,” according to the study, authored by Julie Gaither, an assistant professor of pediatrics at the Yale School of Medicine. “In 2021, fentanyl was responsible for the deaths of 40 infants and 93 children aged 1 to 4 years.”

An environment of drugs

When Tennant, who has been in law enforcement for 43 years, started seeing people die from fentanyl, they were adults.

In the past four years, though, the STAT director started seeing reports of fentanyl killing Missouri’s children. And he admits that was tough, especially when the kids are so young.

“When they’re under 5, they rely on somebody else for everything, to totally care for them,” Tennant said. “And when a child under 5 dies of an overdose, somebody dropped the ball. And as far as I’m concerned, it should be criminal.”

One report he reviewed “sticks in my mind.” A child playing in an urban park in Missouri, he said, picked up a wrapper and put it in his mouth. The little boy died from fentanyl poisoning.

Caitlin Whaley, DSS’ communications director, said that situation is “more of an exception than a rule.” What Missouri is typically seeing, she said, is young children exposed to fentanyl in their homes. Either by a family member or a friend of a family member who brings the drug into the home.

“It’s challenging, because you’re dealing with people that are working through addiction, and we know that people who are working through addiction don’t necessarily have the best judgment,” Whaley said. “And so you have to figure out how to get a very difficult message to a group of people that are dealing with active addiction or connecting with family members that are in active addiction.

“And they’re not recognizing the risks to children.”

Jean Peters Baker, Jackson County prosecutor, said she was stunned to hear that seven children ages 2 and under died last year from fentanyl in her county. She said she only knew of three deaths and was able to file charges in two of those cases.

But she didn’t know about the other four until The Star told her.

“It is shocking — kids shouldn’t die,” Baker said. “When I hear something like this, it kind of makes my hair fall out ... usually, too, they live such a tough life before their death.”

In Kansas, 13-month-old Lucca Lien died in July 2022 after becoming unresponsive during an overnight visit with his father at a Wichita motel. Toxicology screening showed “very high levels of fentanyl in the (boy’s) heart blood and brain tissue,” according to his autopsy report, and his cause of death was “fentanyl toxicity.”

Prosecutors charged his father, Jordan Wayne Lien, with first-degree murder and other crimes. While on bail, Lien died earlier this year in a motel near Wichita from what his lawyer said was a possible drug overdose.

Sometimes, like in Lucca’s case, law enforcement may not know how small children get ahold of the illicit drug that killed them. And it’s only later, after toxicology test results come back, that medical examiners may discover what took the child’s life.

In mid-November 2020, Merriam police found 2-year-old JayPee Luciano Morales unresponsive inside a home. Medical examiners later found that fentanyl was in the child’s system and concluded that it had caused the death, according to Johnson County prosecutors.

Both parents were charged in JayPee’s death. His mom, Shelly Christine Vallejo, pleaded guilty to second-degree murder along with aggravated endangerment of a child and felony possession of fentanyl and was sentenced in February to 10 years in prison. His dad, Jean Pierre Morales, pleaded guilty to distributing drugs that resulted in the boy’s death and in March received a nearly 14-year sentence. Another man, Jared Barraza, also pleaded guilty to distribution of drugs causing death and was sentenced to nine years.

In April of last year, a Jackson County 2-year-old, O’Lijah Gardner, choked and died soon after eating pizza inside a hotel room. His death was initially ruled an accident. Tests showed that he had fentanyl and some methamphetamine in his system.

In the hotel room, officers found drug paraphernalia “to include baggies of unknown substance, residual marijuana, syringes, tools associated with narcotic activity, and Narcan.” The Kansas City Crime Laboratory determined that the baggies contained acetaminophen, para-fluorofentanyl and fentanyl.

“The drug level alone (without choking) would be fatal in an adult and child,” said Ransom Ellis, a pathologist with the Jackson County Medical Examiner’s Office, according to the probable cause affidavit detailing charges against the boy’s mother. “I believe the child was alive when the pizza was placed in his mouth as it appeared inhaled deep into the airway.”

The affidavit also stated that “it was further determined that the amount of fentanyl in the victim’s system would most likely have occurred shortly before his death.”

His mother, Christina A. Gardner, was indicted by a grand jury and is awaiting a trial scheduled for March.

Authorities fear there will only be more JayPees and O’Lijahs die because of what their parents bring into the home.

That’s why Tennant, who has worked many drug cases in his career — from heroin and cocaine to methamphetamine — calls fentanyl “frightening.”

“I didn’t see kids dying from those other drugs like I’m seeing kids die from fentanyl,” Tennant said. “Never in 43 years. Never.”

Young lives lost

Obituaries for the Jackson County children who died last year provide some details from their short lives.

One was a sweet, happy girl with an infectious smile who “was loved by everyone who was blessed to meet her,” her obituary said. She was just 20 months old when she died on Jan. 11, 2022. The bubbly child who called herself “JoJo” loved watching Elmo on TV and would sing and dance when “Elmo’s World” came on.

Another died Oct. 11, 2022, in Kansas City, two and a half months after his second birthday. One of 12 siblings, he enjoyed dancing and wrestling, his obituary said. And he loved the “Baby Shark” song, playing football and playing with his cousins.

A little girl whose nickname was “Toots” had “a smile of gold,” her mother’s attitude and was her dad’s “mini me,” her obituary said. She died May 28, 2022, one month shy of her second birthday. She loved CoComelon and “Baby Shark” and could be heard singing that song all day long.

“Toots’ favorite food in her words was her ‘Chee Burger,’” her obituary said. “Cereal you couldn’t eat a bowl in peace without Toots coming over for some ... (she) was something special from the time she was in the womb feeling her kicks to the arrival of her birth. ... She truly made our world complete.”

One boy was “full of life, laughter, and love,” his obituary said. “(He) loved spending time with his mother, father, cousins, and spending time in his cars,” it said. “(He) loved his toys and going to Chuck E. Cheese. He was such a joyful spirit and brought happiness to everyone.” He died on June 1, 2022, at 20 months.

And another girl, just 10 months old, died at Children’s Mercy in Kansas City on June 4, 2022. She “enjoyed watching, dancing, and singing to ‘Akili and Me,’” her obituary said. But what she loved to do most, it said, was play with her big brother.

Mother knew ‘he was dead’

There was no public obituary for Cillian Miller. The only known details about him come from the affidavit describing charges against his mother.

Officers went to the home in the 6500 block of The Paseo on a “residence check” call just after midnight on Aug. 17, 2022. An anonymous caller had reported that a child at the home “was killed and the child’s mother did nothing to prevent it,” according to court records.

As officers attempted to contact someone inside, additional calls came in about a dead child at the residence.

Once police got inside, they found a boy asleep on the floor between a bedroom and the bathroom.

“The juvenile was alive and carried out of the residence with no apparent injury,” the court affidavit said.

A police sergeant found the second boy on the bed, covered by a blanket.

“The sergeant removed the blanket and observed that the child was unresponsive and hard to the touch,” records said. “Members of the KCPD Homicide Unit-1030 squad were notified of the deceased juvenile’s death and responded to the scene.”

Michaela Chism, the child’s mother, later spoke with police. She said that she and her sons had been staying at the residence on The Paseo for about two weeks.

“Chism advised that multiple (people) came and went from the residence in the two weeks that she stayed there,” the probable cause affidavit said. “Chism stated that people, including herself, consumed controlled substances ... and identified two drugs that she consumed there as methamphetamine and Fentanyl.”

She told police that she and her sons usually slept on the living room couch and chair, court records said. On the previous night or the night before that, she said, she woke up and began watching television.

“Chism noticed that (Cillian) was not moving and went over to check on him,” the affidavit said. “(The little boy) was not responsive and Chism knew that he was dead.”

Chism, now 37, pleaded guilty in March to endangering the welfare of a child involving drugs and first-degree involuntary manslaughter. She was sentenced to six years in prison.

Searching for prevention measures

Substance abuse has always been a “driver” of child abuse and neglect incidents inside families, said van Schenkhof, of the Children’s Trust Fund of Missouri.

But what’s happening with this most recent drug epidemic, she said, is a bit different.

“I think what is new about this is that the fentanyl and the potency of fentanyl is actually causing children to die,” she said, “versus behaviors, abusive or neglectful behaviors, on the part of parents who are abusing substances. That has been happening forever.

“But the piece where children are accidentally gaining access to fentanyl, and because of the potency of it are dying from it, is relatively new. ... Fentanyl is certainly driving child fatalities in the state of Missouri and probably nationwide as well.”

Organizations and groups that work to prevent child abuse and the deaths of Missouri’s children are just beginning to study what is happening and why. They have to know exactly where in the state children are dying of fentanyl, how the kids are getting ahold of the drug and in what situations before they can begin to talk about prevention steps.

One thing that could eventually help in that endeavor, Frazier said, is research Children’s Mercy is in the early stages of conducting on fentanyl and the deaths of young kids. Using information from the National Child Fatality Review Panel database for Missouri, researchers will aim to “characterize the deaths from fentanyl” to see if “we can paint a picture of what’s going on in these children’s lives to help guide our prevention efforts.”

“(They’ll) try to get some more of that information to help us see (if there) are certain characteristics,” Frazier said. “Are there trends that we can see that would allow us to better determine prevention efforts that may be most impactful?”

On top of that, the state Child Fatality Review Panel, which she chairs, will continue to discuss the issue and what measures can be taken to educate families.

“A lot of times it doesn’t take very much fentanyl to cause the child to be very ill or to even die,” Frazier said. “And so I think a lot of times caregivers just aren’t aware of the risk. They really underestimate.”

When it comes to other potential harms against children, prevention tips have been offered for years.

“We talk about cabinet locks to keep your cleaning solutions up and out of the way, and storing them high,” Frazier said. “There’s lots of education around other childhood injury prevention.”

Just not with fentanyl. Yet.

“There’s not the same kind of awareness around making sure that environment that the child is in is safe and secure,” Frazier said. “Fentanyl is out in the community, it’s in the homes, and kids are exploring and finding it.”

She and others say education needs to come fast.

“As these numbers continue to go up and up and up, and people realize it’s not just a blip on the radar but a continued trend that we’re seeing increase year after year,” Frazier said, “that sense of urgency is really, really setting in.”

The Star’s Bill Lukitsch contributed to this report.