SBS: Shaken Baby Syndrome is on the rise

By Staff Reports

 | Friday, 07 December 2012 

An infant may spend 2 to 3 hours a day crying. To top that off, 20 - 30% of infants may even exceed that amount of time crying. This can be very overwhelming to a new parent – no matter how much you love and want to nurture your baby.

A parent or caregiver may momentarily succumb to the frustration of responding to a crying baby by shaking their baby. In some cases, caregivers aren’t prepared for children or are under duress and can’t deal with the frustrations of parenting a crying baby on top of all of life’s other stressors. In other cases, the parent or caregiver may personalize the infant’s crying as being an inadequate parent. Most of these parents love their child, do not use drugs or drink alcohol to excess, and live in clean houses.

While statistically those in lower socioeconomic conditions, young parents, single parents, low levels of education are at an increased risk, the presence of those factors does not predict a specific individual. Child abuse occurs at all levels of society and education. While parents who were abused as children are at an increased risk of abusing their children, the majority of parents who were abused do NOT abuse their children.

“Shaken baby syndrome,” now being referred to as “abusive head trauma” – to acknowledge the different mechanism associated with, and age ranges afflicted – usually happens when a parent or caregiver is angry and loses control. Abusive head trauma (AHT) is the leading cause of death for child abuse and the most common cause of traumatic brain injury in infants. AHT occurs from shaking, or being slammed onto or by hard or soft objects.

According to the Centers for Disease Control and Prevention, of the almost 2,000 children who die from abuse or neglect each year, abusive head trauma (AHT) accounts for 10 -12% of them. Most commonly, the victim of AHT is between 3 and 8 months old; however, it has been reported in newborns and in children up to 4 years of age. In addition, 25% of all children diagnosed with shaken baby syndrome die from their injuries. Even children who don’t die suffer severe consequences from it: 30% leave the hospital with neurologic defects and the children without immediate injury usually have neurologic/cognitive/motor defects when followed over time.

Many infants that later suffered from AHT had prior injuries (sentinel injuries) – most commonly a bruise, but also ractures, burns or other injuries. Had these injuries been recognized as early indications of abuse, these infants may have been spared the devastating effects of AHT.

Various studies and data sets indicate that the rates of severe child abuse are increasing. Just at Miller Children’s Hospital Long Beach alone, then the number and severity of child abuse cases are rising. While it’s important for physicians, nurse practitioners, physician assistants, nurses, and social workers to be able to recognize early signs of abuse in infants and young children, it is just as important for friends and families to pay attention to and recognize increased stress in parent’s lives to prevent child abuse and AHT.

AHT is preventable. Studies have found that parental education programs about crying can decrease the number of cases of AHT. It is important for parents to understand the characteristics of crying and reassure themselves to the fact that sometimes no matter what you do the crying cannot be soothed. But there are soothing techniques that can help alleviate the stress and it is important to remember that it is okay to ask for a break.

Tips to Soothe A Crying Baby

First, Meet Basic Needs:
• Feed the baby
• Burp the baby
• Change the diaper
• Make sure clothing isn't too tight
• Make sure baby isn't too hot, or too cold

Next, try these techniques:
• Take the baby for a walk outside in a stroller or for a ride in the car seat
• Hold the baby against your chest and gently massage the baby
• Rock, walk, or dance with the baby
• Be patient; take a deep breath and count to ten
• Call a friend or relative that you can trust to take over for a while, then get away, get some rest, take care of yourself
• Offer a pacifier
• Lower any surrounding noise and lights
• Offer the baby a noisy toy; shake or rattle it
• Hold the baby and breathe slowly and calmly; the baby may feel your calmness and become quiet
• Sing or talk to the baby using soothing tones
• Record and playback a sound, like a vacuum cleaner, or hair dryer