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The deadly shake: A danger for infants

January 14, 2007|by BOB MAGINNIS

There has been no trial and no one has been convicted in the death of 4-month-old Justice Calvin Stotler, but Dr. Alan Walker, a certified specialist in "shaken baby syndrome" at the Johns Hopkins Hospital said the child's injuries were the worst he had seen in his 30 years of practice.

Unfortunately, this is not a rare occurrence. In 2005, a Greencastle, Pa., couple was convicted after both admitted they had shaken their infant son. And almost every year, from 1999 to the present, The Herald-Mail archives chronicle at least one case in which someone has attempted to quiet a child by violently shaking the infant.

Across the nation, the National Center on Shaken Baby Syndrome estimates that each year 1,300 to 1,400 children are taken for treatment after being shaken. Twenty-five percent of those children will die and of those who survive, 80 percent will have permanent brain damage. Whether that's the extent of the problem is unknown, because there are often no external signs of abuse.

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According to Amy Wicks, the center has been in existence for about a dozen years, but really took off when its staff attended a conference run by the Center for the Prevention of Child Abuse.

"After the conference, we had all sorts of people calling for information. We were inundated with all these calls," she said.

So they wrote some grants, ramped up the operation and were incorporated in 2000. Wicks said that since then awareness of the syndrome has grown and both the American Academy of Pediatrics and the National Association of Medical Examiners have put together reports advising their members how to recognize it.

Asked to define the syndrome, Wicks said that "I would call it injuries, including bleeding in the brain and bleeding in the back of the eyes - retinal hemorrhages - caused by a violent whiplash motion.

"You have blood vessels in the brain that tear and that also cuts off the supply of oxygen to the brain. You can also have damage to the eyes, to the optic nerves and fractures of the long bones," Wicks said.

The pediatrics paper states that shaken baby syndrome is rarely, if ever, caused by "such apparently innocent practices such as tossing a baby into the air and other playful maneuvers.."

Instead, the paper says that significant brain injury is thought to be caused by "holding the child by the thorax or an extremity and violently shaking the child back and forth, causing the head to forcefully whiplash forward and backward with repeated accelerations and decelerations in each direction."

What would cause a parent or care-giver to commit such a violent act upon a child?

"Usually, when a reason is given," Wicks said, "the child is crying and the care-giver becomes frustrated and shakes the child."

There is not a single profile of people who are likely to do these things, Wicks says.

"It really crosses all the socio-economic lines," she said, adding that the abuser can be anyone from a young father to a middle-aged care-giver.

Fortunately, the center, located in Utah, has developed a program that has worked there and in New York State to reduce the number of such cases.

Instead of just putting a brochure on shaken baby syndrome into a new mother's hospital package, Wicks said the program has nurses talk to new parents.

"They may not ever read the brochure, but they figure if someone is talking to them about it, it must be important," Wicks said.

They are told that "your baby will cry more than you ever imagined. If you begin to get too frustrated, it is all right to put your baby in he crib and walk away for a while."

Research cited by the center shows that all babies go through stages of crying and that healthy babies cry more and more each day as they develop.

Studies also indicate that it is normal for a baby to cry even when someone is trying to soothe him or her. It is also normal for a baby to appear to be in pain when crying, even if that is not the case.

If you think the baby is crying too much, the center advises consulting a health-care provider. If there is no physical cause, it is OK to put the crying baby in the crib while you take a break.

But no matter how frustrated or angry you get, center staffers say, don't shake the baby.

Locally, the Washington County Hospital provides parent education as part of its "baby basics" class and in the labor and delivery unit itself.

Nicole M. Jovel, a public relations coordinator at the hospital, said "parents are informed that babies cry because it is their way of communicating. Do not react to your baby crying out of frustration, stress or fatigue.

"Ask someone to help you care for the baby or give you a break if you feel your frustration or stress level rising."

To all of that good advice, I would only add this: Make sure that whoever you leave your baby with, even for a few moments, knows the proper way to handle a baby and is experienced enough so that 10 minutes of wailing won't provoke an incident that will lead to your child's severe injury or death.

For more information, visit the shaken baby syndrome center's Web site at www.dontshake.com.




Bob Maginnis is editorial page editor of The Herald-Mail newspapers.

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