Pathologist Professor Peter Berry, for the prosecution, said in his opinion the two children had been suffocated and were not victims of sudden infant death syndrome or cot death.

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Her husband Kenny and two other children, Jodie and Jack, were not at home.

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The two mothers of Sand's three children were not in the courtroom for Thursday's proceeding, but Obedin has said he has contacted them and claimed their priority is for Sand to be free to earn a living so he can repay his debt.

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She is also alleged to have let children under two use the playhouses despite knowing they were not suitable for that age group.

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Although this particular study did not look at reasons that the parents were or were not providing their children with supplements, Shaikh points toward two main factors that may be at play, which she finds equally challenging: lack of parental financial ability and lack of public health education for parents of lower income families.

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Of the 341 early years staff who responded, 95% said they were concerned about increasing childcare ratios and that practitioners caring for children aged two or under should not be looking after any more.

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