A kilogram of fentanyl was found under nap mats at a nursery in New York where one child died and three others were taken to hospital, police say.
Police believe the children, ranging in age from 8 months to two years old, inhaled the powerful narcotic drug at the Bronx nursery last week.
Three children were given Narcan, an emergency medication used to reverse opioid overdose.
Drug conspiracy and murder charges have been filed against two people.
Nicholas Dominici, who was due to turn two in November and had attended the nursery for just one week, died of a suspected drug overdose on Friday.
A search of the nursery turned up one kilo of fentanyl that was discovered “underneath a mat where the children had been sleeping earlier”, said NYPD chief detective Joseph Kenny on Monday.
They also allegedly discovered three presses used to package kilos of drugs, investigators say.
The owner of the Divino Niño nursery in the Bronx, Grei Mendez, 36, and her tenant Carlisto Acevedo Brito, 41, are facing federal charges of narcotics possession “with intent to distribute resulting in death and conspiracy to distribute narcotics resulting in death”, according to federal prosecutors.
“The defendants poisoned four babies and killed one of them because they were running a drug operation from a daycare centre,” Manhattan US Attorney Damien Williams said at a news conference on Tuesday.
Fentanyl, a synthetic painkiller 50 times more powerful than heroin, has been blamed for an increase in drug deaths. Police say the drugs recovered from the nursery could have killed 500,000 people.
Surveillance footage and phone records show that Ms Mendez called her husband after finding the children ill – moments before she contacted 911. Her husband then arrived and removed several full shopping bags from the nursery, officials said.
Authorities are still searching for her husband, who has been identified in court documents as a co-conspirator.
A lawyer for Ms Mendez said his client denies the charges and was unaware that drugs were being kept in the nursery.
“Her only crime was renting her room to someone who had a kilo,” said her lawyer, Andres Aranda, according to ABC News.
“There is no evidence that she did anything but care properly for these children.”
It is unclear whether Mr Brito, who is a cousin of Ms Mendez’s husband, has a lawyer.
Both suspects have been labelled as flight risks by authorities and are being held without bail. They each face life in prison if convicted.
City health inspectors conducted a surprise visit of the nursery on 6 September, but did not identify any violations, said City Health Commissioner Ashwin Vasan.
“I’m very sorry, but one of the things that my childcare inspectors are not trained to do is look for fentanyl. But maybe they need to,” he said at a news conference on Monday.
Mayor Eric Adams at the news conference called for a “full national assault” on the drug, and alluded to its potency.
“A tenth of a size of a fingernail can kill an adult. So imagine what it could do to a child,” he said, holding up a photo showing a lethal dose in comparison to a one cent coin.
Virtually every corner of the US, from Hawaii to Alaska to Rhode Island, has been touched by fentanyl, research shows.
In 2010, less than 40,000 people died from a drug overdose across the country, and less than 10% of those deaths were tied to fentanyl.
By 2021, over 100,000 people died in drug overdoses, with an estimated 66% of those tied to fentanyl.