A woman has been charged with murder after allegedly killing her one-year-old grandson by rubbing methadone on his gums.
Baltimore police said Towanda Reaves, 50, was arrested and charged over the boy's death on August 1.
She was also charged with assault after allegedly administering the drug to her infant granddaughter.
The charges date back to July 5, when officers responded to a pre-dawn call in the city's northwestern neighbourhood of Franklintown, after paramedics tried to resuscitate the baby boy.
Reaves allegedly told officers she had put the children to bed at 8pm the night before and then checked on them at 2am. She said the boy was snoring at that time.
Two hours later Reaves said she got up to turn an air conditioning unit off but noticed the boy was not breathing.
The boy's father was asleep on a living room sofa at the time, she said.
After placing an emergency call paramedics failed to revive the child, who showed no signs of physical injury, and he was pronounced dead at Sinai hospital at 4.52am.
Police said Reaves had stayed at the house to look after two other grandchildren and at 2pm on July 5 the young girl, who was three months younger than the boy, was admitted to the intensive care unit at the hospital.
Medical staff performed a toxicology test on the girl and it indicated methadone was in her bloodstream.
Methadone is a synthetic opiod which is used as an analgesic and as a prescription to help wean people off drugs such as heroin and morphine.
Detectives said Reaves had given an empty methadone bottle to medical staff and allegedly admitted rubbing methadone into the gums of the two children.
Last Wednesday, the chief medical examiner listed methadone intoxication as the boy's cause of death.
Police charged Reaves with second-degree murder, child abuse resulting in death, assault, child abuse causing serious injury and reckless endangerment.
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