They gave the young children the overdose-reversal medication Narcan and took them away.
Another 2-year-old-boy, who had left the small ground-floor day care centre shortly after noon, was taken to a hospital after his mother noticed an unusual lethargy had replaced a toddler’s normal energy.
Nicholas was pronounced dead at Montefiore Medical Center on Friday.
By early Saturday, the other three children were in critical or stable condition.
After an autopsy on Saturday, the New York City medical examiner’s office said further examination was needed to determine Nicholas’ cause of death.
Mr Joseph E. Kenny, the Police Department’s chief of detectives, said at a news briefing on Friday that police suspicions about opioid exposure were prompted by the children’s symptoms and by the discovery of a so-called kilo press – commonly used by drug dealers when packaging large quantities of drugs – at the day care during a search.
The opioid was not identified, but during Friday’s briefing, Mayor Eric Adams and Dr. Ashwin Vasan, commissioner of the Department of Health and Mental Hygiene, described the dangers of fentanyl and the drug’s pervasiveness.
“This crisis is real, and it is a real wake‑up call for individuals who have opioids or fentanyl in their homes,” Mr Adams said.
Fentanyl, a highly potent drug used to treat moderate to severe pain, can be fatal in small doses if it is ingested or injected, said Dr. Paul Christo, an associate professor and pain specialist at the Johns Hopkins University School of Medicine.
Two milligrammes, the equivalent of 10 grains of salt, are enough to kill an adult who ingests that amount.
But simply inhaling or touching fentanyl is “highly unlikely” to be fatal either to an adult or a small child, Dr. Christo said.
Ms Dominici learned what happened to her son when she arrived at the day care at 3pm on Friday to pick him up, she said on Sunday.
She saw police surrounding the building and Mendez inside crying, she said.
Then she got a call from a coordinator of the programme telling her Nicholas was in the hospital.
Nicholas was very intelligent, his mother said on Sunday. “When he saw I was sad, he said, ‘Mommy, what’s wrong?’ He would look at you with these eyes like he understood. He was very special.”
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