Rachel Nelson's baby stopped breathing at least 15 times in just the first four months of his life.
Sometimes, the little boy would simply start breathing again on his own. But sometimes, his father needed to perform CPR.
And once, when an episode occurred at Children's Hospital of Pittsburgh of UPMC, life support had to be used.
Prosecutors say there was nothing medically wrong with the boy, and that instead each incident was caused by Nelson purposely clutching her son against her chest. She was trying to kill him.
In July, Nelson, of Costa, W.Va., pleaded guilty in Allegheny County to aggravated assault, recklessly endangering another person and endangering the welfare of children for the local hospital incident.
On Thursday, Nelson was sentenced to one to two years in the Allegheny County Jail based on two of those incidents that happened at Children's Hospital in October. While the boy continues to be monitored, he does not appear to have any lingering effects from what happened.
"That's the only thing that is a ray of light," defense attorney Tricia Beth Henning said. "Everything else is sad."
A Boone County, W.Va., grand jury is investigating, and additional charges could be filed in the next several months.
According to police, the infant was transferred to Children's from a West Virginia hospital in October to be evaluated for repeated episodes of apnea and hypoxia and possible child abuse.
On Oct. 19, the baby's father alerted nurses that the child was not breathing, and he was successfully resuscitated. The next night, the boy was discovered limp and not breathing normally. He received 30 minutes of life support and recovered.
A video reviewed by doctors at the hospital showed Nelson blocking the view of the infant, and she was the only person in the room with him, police said.
Nelson later admitted to trying to smother the infant against her chest because she wanted to kill him and herself to escape her husband and his controlling nature.
"In her mind, she thought the only way out was to kill [him]," Ms. Henning said.
Allegheny County Common Pleas Judge Anthony M. Mariani dismissed that.
"That's not very persuasive to the court," he said.
Ms. Henning told the judge her client has been diagnosed with bipolar disorder and major depression and that she needs significant mental health treatment.
According to assistant district attorney Lisa Carey, Nelson has been receiving mental health treatment since she was 2 years old and that it continued -- including therapy and the use of medication -- until shortly before her arrest.
After charges were filed, she spent three weeks at Western Psychiatric Institute and Clinic.
As Judge Mariani weighed his options in sentencing, he said the element of intent in the case is substantial.
"She tried to kill her child," he said. "One of the reasons this case is abhorrent -- it's hard to picture a mother intentionally trying to kill her own infant."
Judge Mariani said he did not believe Nelson to be evil but that she needs treatment.
"We don't judge you personally. We don't judge you morally," he said. "None of us in here has the right to do that. But we do judge you legally."
As part of the sentence, Ms. Henning may ask the court at 18 months to have Nelson transferred into an alternative housing program that would provide intensive therapy. Her sentence also will be followed by five years of probation.
As part of her sentence, Nelson may not have contact with any minors. Her son is in the custody of his father, and whether she receives visitation or custody in the future will depend on a decision of the West Virginia courts.
Nelson's husband has served her with divorce papers, Ms. Carey said. Nelson has sent him letters asking for his forgiveness, and saying she has forgiven herself. She did not speak on her own behalf at sentencing.
In terms of additional criminal charges, Boone County assistant prosecutor Justin Marlowe said the grand jury will be meeting there in two weeks, and again in January. He suspects charges will not come from the panel this month.
"We were waiting for what Pennsylvania did," he said. "It was really kind of wait and see. We're still planning on going forward."
Ms. Carey said that in the Allegheny County case the prosecution was seeking a sentence in the standard range of the guidelines, which would have called for 22 to 36 months.
"Were the defendant's efforts successful, you would never get out of jail again for the rest of your life," Judge Mariani said. "The fact that the child has survived is significant. The fact that the child has survived without any lasting injuries is very significant."
Paula Reed Ward: email@example.com, 412-263-2620 or on Twitter @PaulaReedWard.