On Christmas Eve, an 8-year-old Guatemalan boy who suffered a cough, vomiting and fever died in U.S. custody at a New Mexico hospital. The boy, identified by Guatemalan officials as Felipe Gomez Alonzo, was the second child in three weeks to die while being detained near the U.S.-Mexico border by U.S. authorities.

Jakelin Caal, 7, also Guatemalan, died Dec. 8. at an El Paso children's hospital after being detained with her father and while preparing to travel by bus to a Border Patrol station in New Mexico.

The back-to-back deaths prompted an outcry from immigration activists, politicians and human rights groups and raised questions about the Trump administration policies that have separated children and parents and filled detention centers.

How did they die?

Felipe, along with his father, had been detained for a week after trying to cross the border illegally near El Paso on Dec. 18. Because of "capacity levels" in El Paso, they were moved to the Border Patrol station at Alamogordo, New Mexico, two days later, the CBP said. The next day, Felipe was sent to a hospital after a border agent noticed Felipe was coughing and had “glossy eyes,” the CBP said.

After being diagnosed with a cold and a fever, Felipe was prescribed amoxicillin and Ibuprofen. The CBP said he was held 90 minutes for observation and released Monday afternoon. That evening, he was sent back to the hospital with nausea and vomiting and died hours later.

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Jakelin died two days after a grueling trip through the desert with her father along with 161 other migrants who had crossed the New Mexico border illegally. They were initially taken to a base in rural New Mexico that did not have running water, according to Democrats who visited it after the girl’s death.

Jakelin and her father were scheduled to travel by bus to a Border Patrol station in New Mexico when her father, Nery Gilberto Caal, told Border Patrol agents she was sick. She was taken to a children's hospital in El Paso where she died.

Are such deaths in U.S. custody common?

Kevin McAleenan, commissioner of Customs and Border Protection, tells "CBS This Morning" that the latest death is a "tragic loss" but also a "rare occurrence."

"It's been more than a decade that we've had a child pass away anywhere in a CBP process so this is just devastating for us," he says. "We've got over 1,500 emergency medical technicians that have been co-trained as law enforcement officers. They work every day to protect people that come into our custody."

Secretary of Homeland Security Kirstjen Nielsen said six people have died while in Border Patrol custody during Fiscal Year 2018, which ended in September, but that none were children.

Nielsen's statistics were provided five days after her testimony before the House Judiciary Committee in which she was unable to say how many people had died in Department of Homeland Security custody.

"I don’t have an exact figure for you,” Nielsen replied to a question by Rep. David Cicilline, D-R.I.

Pressed again whether she had even a rough idea of many people had died in her department's custody, she said, “I will get back to you with the number.”

Why are there suddenly two deaths this month?

Rep. Joaquin Castro, of Texas, said many questions remain unanswered regarding the deaths, but noted the "lack of adequate medical supplies, equipment and resources" at CBP detention facilities to treat migrants and the agents working there.

Castro also suggested that many more migrants were taking more dangerous paths into the country because of the Trump administration's policy of turning asylum-seekers away from legal ports of entry. This policy, he said, was "putting families and children in great danger."

Nielsen, in a statement on Tuesday, blamed an immigration system that has been "pushed to the breaking point by those who seek open borders," including smugglers, traffickers "and their own parents who put these minors at risk by embarking on the dangerous and arduous journey north."

She said the Border Patrol has detailed 139,817 migrants on the Southwest border in the past two months, compared to 74,946 for the same period last year. These include 68,510 family units and 13,981 unaccompanied children.

"Given the remote locations of their illegal crossing and the lack of resources, it is even more difficult for our personnel to be first responders," Nielsen said.

McAleenan, the CBP commissioner, says Border Patrol stations "are not built for that group that's crossing today."

"They were built 30 to 40 years ago for single adult males, and we need a different approach," he tells CBS. "We need help from Congress. We need to budget for medical care and mental health care for children in our facilities."

Children who arrive unaccompanied by a parent are supposed to go to longer-term facilities operated by the U.S. Department of Health and Human Services. But HHS’ system is also strained. The Associated Press reported this month that 14,300 children were being detained by HHS, most in facilities with more than 100 kids.

Homeland Security’s inspector general examined nine CBP holding facilities earlier this year. In a September report, the IG said that the facilities complied with CBP standards and that people had access to food and water, toilets and sinks, and hygiene items – with “the exception of inconsistent cleanliness of the hold rooms.”

Just three of the nine facilities had “trained medical staff to conduct medical screening and provide basic medical care,” the report said. Showers were available for unaccompanied children at only four facilities.

How has the administration responded to the latest deaths?

Nielsen ordered that all children in Border Patrol custody undergo a thorough, secondary medical screening and that in the future "all children will receive a more thorough hands-on assessment at the earliest possible time post apprehension – whether or not the accompanying adult has asked for one."

She said she has asked the Centers for Disease Control and Prevention to send experts to investigate the rise in sick children crossing the borders and to identify additional steps hospitals along the border should take to prepare for and to treat them.

In addition, Nielsen said she has asked the U.S. Coast Guard Medical Corps to assess CBP’s medical programs and recommend appropriate improvements. She also sought assistance from the Department of Defense, the Federal Emergency Management Agency and the Department of Health and Human Services.

Customs and Border Protection, which did not notify Congress about Jakelin's death for days, said it would follow new procedures when someone dies in its custody. The procedures include notifying lawmakers within 24 hours of any death.

Contributing: Lindsay Schnell and Kevin McCoy, USA TODAY; The Associated Press

