Anne Hart December 20 2010
The Chatham County parents of a 10-month-old baby boy fully understand that shaken baby syndrome is a real and dangerous public health problem.
They in no way want to downplay the fact that shaking an infant can cause severe and irreparable damage to a child.
What they do want people to realize is that sometimes a baby showing some signs of shaken baby syndrome may be suffering from a different, unrelated medical condition, one that does not involve abuse.
They believe this because that's what happened to them.
The parents are sharing their story as a cautionary tale. They say there's a need for closer scrutiny when making such a harsh diagnosis as shaken baby syndrome.
Their names are being withheld to protect the privacy of their son.
The parents say that earlier this year, their only child - the child they call their "miracle baby" because they had tried for a year and half to conceive - was misdiagnosed with shaken baby syndrome.
This commenced a nightmare that included temporarily losing custody of their then 5-month-old son for 56 days and spending roughly $60,000 in the legal battle to regain custody.
The case was eventually dismissed, and the baby was returned to his parents.
"There is abuse of children out there," said the baby's father. "But we are not that family."
Their son turned out to be suffering from chronic subdural hematomas, which they say is a possible complication of being born one-month premature. The baby weighed 3 pounds, 4 ounces at birth and spent a month in the neonatal intensive care unit.
Today, the baby is doing well. His parents take him regularly to Atlanta to be treated for the hematomas.
The parents are also dealing with the emotional and financial fallout caused by the case and worry about other children being misdiagnosed with shaken baby syndrome.
Protecting babies
About 1,500 babies younger than age 2 in the United States are diagnosed with shaken baby syndrome each year, according to MedicineNet.com.
Since the early 1990s, many hundreds of people have been imprisoned on suspicion of murder by shaking.
But according to media reports, there is some question regarding the science behind diagnosing SBS.
According to a Sept. 20 New York Times Op-Ed: "For the past 30 years, doctors have diagnosed the syndrome on the basis of three key symptoms known as the "triad:" retinal hemorrhages, bleeding around the brain and brain swelling. The presence of these three signs (and sometimes just one or two of them) has long been assumed to establish beyond a reasonable doubt that the person who was last taking care of the baby shook him so forcefully as to fatally injure his brain. But closer scrutiny of the body of research that is said to support the diagnosis of shaken baby syndrome has revealed methodological shortcomings. Scientists are now willing to accept that the symptoms once equated with shaking can be caused in other ways."
Pediatric neurosurgeon Dr. David M. Wrubel of Children's Healthcare of Atlanta sees about 50 babies a month, if not more, who show the signs of shaken baby syndrome. He said it's rare that the cases turn out to be something else.
"Unfortunately, with the majority of cases, it's shaken baby syndrome or some other type of abuse,'' Wrubel said. "There are always the unusual cases, such as chronic subdurals. That does happen, but not frequently."
Wrubel is now treating the Chatham County child for the hematomas. Neither Wrubel or Children's Healthcare of Atlanta were involved in the initial treatment.
Wrubel said the system is set up to make sure the child is protected. He said it's a tough situation because the parents or caregivers are considered guilty until proven innocent to protect the safety of the child.
"There's not an epidemic (of misdiagnosed shaken baby syndrome cases),'' Wrubel said. "But unfortunately, sometimes innocent people get swept up in the process to protect the safety of the child."
Contact Anne Hart at anne@southernmamas.com.
http://savannahnow.com/accent/2010-12-19/hart-heart-shaken-baby-parents-share-story-help-others
Showing posts with label prematurity. Show all posts
Showing posts with label prematurity. Show all posts
Sunday, 26 December 2010
Thursday, 23 September 2010
SIDS: Born too small … Born too soon
September 3, 2010
by Ahimsa Porter Sumchai, M.D.
I was a 5-pound baby with a perfectly round, perfectly bald head at birth, according to my cousin Ellen Shipp. Like many small for gestational age (SGA) and premature infants, my tiny head was not deformed when I passed through the birth canal of my mother, Mildred Porter. I was lucky. I was a healthy baby – but always ended up being one of the smallest pupils in a given classroom … all the way through medical school!
Many babies born too small and too soon are at higher risk for sepsis, pneumonia, hypoglycemia, temperature instability, feeding difficulties, brain damage, seizures and apnea compared to babies born full term.
According to Dr. William Callaghan, the senior scientist of the Centers for Disease Control’s Maternal and Infant Health Branch, in testimony before the congressional subcommittee on health, “The question of why African American mothers are more likely to have a preterm birth, even when socioeconomic and other factors are controlled for, is one of the ‘Holy Grails’ of perinatal medicine.” Many scientists are looking at the role caesarian sections and early induction of labor is having on the rising incidence of preterm births in our countries.
Some of you have heard horror stories about women whose labor was induced because it was in some way convenient for family or health care providers for her to give birth more quickly. The health of the mother and the health of the baby are the only driving considerations in the decision to induce an early labor and delivery.
By now most of you know that African American women have the highest infant mortality rates in Bayview Hunters Point, a statistic that is also borne out in national studies. Recent evidence suggests that infant mortality in Black women is linked to a low incidence of breast feeding. The American Academy of Pediatrics recommends breastfeeding as the best nutritional option for all babies.
The preterm birth rate in the U.S. jumped 20 percent between 1990 and 2006. A July 2010 article in Contemporary Pediatrics reports the 2006 Federal Preemies Act authorized an expansion of federal work to prevent preterm birth. It is up for reauthorization next year. Preemies and SGA infants cost about $26 billion to care for in 2005.
Catherine Spong, M.D., of the National Institute of Child Health and Human Development testified before a recent congressional hearing before the House Committee on Energy and Commerce to promote legislation on preterm birth and infant death. An analysis by the National Center for Health Statistics found that in 2005, 37 percent of all infant deaths can be attributed to preterm risk factors. Preterm infants are at higher risk for Sudden Infant Death Syndrome and have higher rates of neurological and developmental disabilities in childhood.
The rising tide of the AIDS epidemic among African American women has changed the face of child health in the U.S. Twenty years ago pediatric doctors were skilled in caring for children with bacterial infections that are now preventable in the developing world by vaccines. Today, antiretroviral therapy given to HIV infected women during pregnancy and to their infected newborns can help to eliminate mother to child transmission of an infection that in the 1980’s killed most congenitally infected babies by the time they reached age 5. An infection that continues to kill HIV infected children in the developing nations of the world.
The most significant health care disparity we face in the United States and locally in San Francisco’s southeast sector remains the unforgivable rates of infant death seen in the African American community. Under the American Recovery and Reinvestment Act of 2009, health care providers who reduce racial and ethnic health disparities in patients can receive incentive payments for demonstrating meaningful interventions that reduce those disparities.
Under the American Recovery and Reinvestment Act of 2009, health care providers who reduce racial and ethnic health disparities, such as the high rates of infant death in Bayview Hunters Point, can receive incentive payments for demonstrating meaningful interventions that reduce those disparities.
The first step involves the collection of data on race, ethnicity and language using an electronic health record system. Using the electronic health record to evaluate and monitor specific disparities can lead to eliminating differences in health care access and outcomes according to the Health Information Technology Policy Committee.
http://sfbayview.com/2010/born-too-small-born-too-soon/
by Ahimsa Porter Sumchai, M.D.
I was a 5-pound baby with a perfectly round, perfectly bald head at birth, according to my cousin Ellen Shipp. Like many small for gestational age (SGA) and premature infants, my tiny head was not deformed when I passed through the birth canal of my mother, Mildred Porter. I was lucky. I was a healthy baby – but always ended up being one of the smallest pupils in a given classroom … all the way through medical school!
Many babies born too small and too soon are at higher risk for sepsis, pneumonia, hypoglycemia, temperature instability, feeding difficulties, brain damage, seizures and apnea compared to babies born full term.
According to Dr. William Callaghan, the senior scientist of the Centers for Disease Control’s Maternal and Infant Health Branch, in testimony before the congressional subcommittee on health, “The question of why African American mothers are more likely to have a preterm birth, even when socioeconomic and other factors are controlled for, is one of the ‘Holy Grails’ of perinatal medicine.” Many scientists are looking at the role caesarian sections and early induction of labor is having on the rising incidence of preterm births in our countries.
Some of you have heard horror stories about women whose labor was induced because it was in some way convenient for family or health care providers for her to give birth more quickly. The health of the mother and the health of the baby are the only driving considerations in the decision to induce an early labor and delivery.
By now most of you know that African American women have the highest infant mortality rates in Bayview Hunters Point, a statistic that is also borne out in national studies. Recent evidence suggests that infant mortality in Black women is linked to a low incidence of breast feeding. The American Academy of Pediatrics recommends breastfeeding as the best nutritional option for all babies.
The preterm birth rate in the U.S. jumped 20 percent between 1990 and 2006. A July 2010 article in Contemporary Pediatrics reports the 2006 Federal Preemies Act authorized an expansion of federal work to prevent preterm birth. It is up for reauthorization next year. Preemies and SGA infants cost about $26 billion to care for in 2005.
Catherine Spong, M.D., of the National Institute of Child Health and Human Development testified before a recent congressional hearing before the House Committee on Energy and Commerce to promote legislation on preterm birth and infant death. An analysis by the National Center for Health Statistics found that in 2005, 37 percent of all infant deaths can be attributed to preterm risk factors. Preterm infants are at higher risk for Sudden Infant Death Syndrome and have higher rates of neurological and developmental disabilities in childhood.
The rising tide of the AIDS epidemic among African American women has changed the face of child health in the U.S. Twenty years ago pediatric doctors were skilled in caring for children with bacterial infections that are now preventable in the developing world by vaccines. Today, antiretroviral therapy given to HIV infected women during pregnancy and to their infected newborns can help to eliminate mother to child transmission of an infection that in the 1980’s killed most congenitally infected babies by the time they reached age 5. An infection that continues to kill HIV infected children in the developing nations of the world.
The most significant health care disparity we face in the United States and locally in San Francisco’s southeast sector remains the unforgivable rates of infant death seen in the African American community. Under the American Recovery and Reinvestment Act of 2009, health care providers who reduce racial and ethnic health disparities in patients can receive incentive payments for demonstrating meaningful interventions that reduce those disparities.
Under the American Recovery and Reinvestment Act of 2009, health care providers who reduce racial and ethnic health disparities, such as the high rates of infant death in Bayview Hunters Point, can receive incentive payments for demonstrating meaningful interventions that reduce those disparities.
The first step involves the collection of data on race, ethnicity and language using an electronic health record system. Using the electronic health record to evaluate and monitor specific disparities can lead to eliminating differences in health care access and outcomes according to the Health Information Technology Policy Committee.
http://sfbayview.com/2010/born-too-small-born-too-soon/
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