FREMONT, Neb. (AP) — A Nebraska man charged with fatally stabbing his 4-month-old cousin was being treated for depression at the time but hadn’t been taking his medicine, according to police.

Nineteen-year-old Alexander Hernandez has been charged with first-degree murder, child abuse and using a weapon to commit a felony in the Jan. 9 stabbing. He appeared in court Tuesday and is being held without bond.

Police said a witness heard the baby girl’s cries and entered the room to find Hernandez stabbing the child several times.

After police arrived at the home, officers found the baby girl with 16 stab wounds. She was pronounced dead at a hospital.