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Shaken Baby Syndrome can be prevented

TINKER AIR FORCE BASE, Okla. -- You've probably heard the sad news on TV frequently -- another infant killed by someone who was entrusted with their safety. You've heard the announcers label the tragedy -- Shaken Baby Syndrome. But how does it happen, and how can this tragedy be prevented?

It typically begins when someone is left alone caring for a baby -- it may be the child's parent, mother's boyfriend or another caregiver. The baby starts crying, as babies naturally do. The caregiver might try changing the baby's diaper, but the baby keeps crying. Feeding the baby doesn't help either. There may be no signs of fever or illness, but the baby cries on. The person may cuddle and rock, or even sing to the baby, but nothing helps. The caregiver becomes stressed, frustrated and angry -- why won't this baby shut up? Sometimes the caregiver experiences irrational thinking -- this baby hates me!

Then the person makes an often fatal mistake. They grab the baby, lift it up and shake it. The shaking is sometimes followed by slamming the baby down in the crib or onto the floor. But the shaking alone is enough to produce horrendous consequences. Twenty-five percent of shaken babies die. The remaining 75 percent can suffer severe significant brain damage. Approximately 60 percent of victims either die from their injuries at a later time or suffer lifetime disabilities. They may become blind, paralyzed, deaf, mentally retarded, have seizure disorders or become developmentally delayed. Of all types of physical child abuse, shaking is recognized as the most common cause of death and accounts for the most long-term disability in infants and young children. There may be no visible sign of injury, and the injuries may not become apparent until the child enters school and shows cognitive and behavioral problems

Perhaps if people knew that crying, even inconsolable crying, is normal, they would be better prepared to deal with it. The National Center on Shaken Baby Syndrome reveals that "The normal infant spends two to three hours each day crying, and 20 to 30 percent of infants exceed that amount of time, sometimes substantially. Infants often cry on an apparently irrational basis, and may not respond to a parent's initial attempts to comfort them."

New Parent Support Nurse Lisa Dunson pointed out "crying is the No. 1 trigger for Shaken Baby Syndrome, so it's certainly no coincidence that most cases occur during the peak age for crying -- the 6 week to 4 month age range." Increased crying during that age bracket is so common that there is even a special name for it -- "The Period of Purple Crying." The National Center on Shaken Baby Syndrome summarizes what PURPLE stands for.

The baby's crying may peak in the first couple of months and then decrease, and he may cry at unexpected times, and parents might not know why. The baby may resist all efforts to comfort and soothe her. Sometimes it may seem that the baby is in pain, but he isn't. Crying may last a long time, even as much as five hours or more. Crying seems to be worse in the afternoon and evening. All of this is normal. Some babies may experience this cycle more than others. "The Period of Purple Crying" DVD and booklet are available and free to new and expectant parents (who are TRICARE beneficiaries) from the Family Advocacy office in the 72nd Medical Group.

A crying baby can be very frustrating to a new parent, who is already stressed and sleep-deprived. A parent may think they are doing something wrong, and they may worry people will think they are bad parents. Even the most kind and loving caregiver can become frustrated by a crying baby.

"These feelings don't make you a bad parent or caregiver," Ms. Dunson said. "Feeling frustrated is normal. If you feel yourself getting upset or angry, put the baby in a safe place, like his/her crib, and take a few minutes to take care of yourself."

She suggested ways to calm down, such as calling a good friend and talking for awhile, listening to some calming music, doing some exercise, working on a hobby or reading.

"Remember the crying will come to an end at some point, and eventually the baby will outgrow this PURPLE stage," Ms. Dunson said. "But your baby will never outgrow the damage caused by shaking him/her. No matter how mad you get, never shake your baby!"

Parents also need to be careful when leaving their baby in someone else's care. Use common sense -- Never let anyone take care of a fussy baby by himself or herself, if:

· They have a hot temper.

· They are afraid of losing control or have been known to lose control in the past.

· They can't pay full attention to the baby.

· They don't know how to handle a child who is difficult to comfort.

· They don't know how to handle a child who is demanding, crabby or annoying.

· They think that babies 0-18 months "do things on purpose to make you angry."

The Family Advocacy Program offers many services for new and expectant parents. Call 734-4390 for more information.