"Never Shake A Baby!"

8 1/2 month-old Matthew Eappen - Newton, 4-month-old Joshua Rabaiotti - Methuen, 5-week-old Colleen
Haskard - Medford, 7-month-old Laura Cashin - Dracut, 8-month-old Raymond Wood, Jr. - Fall River, 11-month-old Brittany Branch - Brighton, and 1-month-old Christopher Livesey - Bridgewater.....

These are but a few of the children in Massachusetts who have died in the past few years from what is known as Shaken Baby Syndrome (SBS) - injuries resulting from vigorous shaking of an infant or small child by a frustrated parent or caregiver often triggered by an episode of crying. Although these children made the headlines, many more victims - children who suffer brain damage, blindness, hearing loss, and sometimes mental retardation from being shaken - never reach the public's attention. And there are still many more whose injuries are never even treated or documented. These children suffer learning disabilities, delays in development, speech problems and other physical and mental impairments.

Shaking is now understood to be the most frequent cause of permanent disability and death among abused infants. Children under two are particularly vulnerable to the effects of shaking because their weak neck muscles are not yet strong enough to fully control their head movements. When a child is shaken, the head whips back and forth slamming the fragile brain tissue against the hard skull, causing bruising, bleeding and swelling inside the brain. When the shaking is combined with throwing the baby against a crib mattress, couch, or hard surface, the final deceleration force can cause blunt impact trauma to the brain that can result in death.

Although many state child protective service departments do not track injuries and deaths directly attributable to Shaken Baby Syndrome (SBS), one retrospective study of fatal child abuse cases over a 20-year period implicates shaking as the cause of death in 13% of cases. Another study in Ohio indicates that 15% of deaths due to child battering or other maltreatment in children under five years old were confirmed cases of SBS. An additional 11% of the cases were questionable as due to SBS, suggesting the possibility that more than one-fourth of preschoolers who died in this 3-year period were shaken to death. It is important to note that some infants who are shaken to unconsciousness but recover may not be seen in a health care setting and, therefore, the association between shaking and subsequent brain damage or delays in learning in these cases may never be established. It is quite likely, then that the incidence of SBS is grossly underreported.

While such tragedies are commonly perceived as the result of cruel, or mentally deranged caretakers, they are more frequently the result of ignorance about infant development and how to cope successfully with infant crying. The majority of SBS shakings, over 60%, are committed by the child's father or the boyfriend of the child's mother. Babysitters and child care workers account for less than 20% of the cases, teenagers for another 10%, and mothers less than 10%. Renowned pediatrician T. Berry Brazelton has found that normal six-week-old infants cry for an average of two hours and forty minutes a day. Yet many people believe that babies wouldn't cry so much if they themselves were better caregivers, a misconception leading to shame, anger, and too often, tragedy.

Though the problem of SBS was originally documented by pediatric radiologist Dr. John Caffey in 1972, there has been a delay in the acceptance of the need for education about SBS. For many years, there was inadequate medical documentation that SBS was a serious problem. Many cases of SBS went undetected due to lack of external indications of injury, lack of witnesses to the incidents, and refusal of caretakers to admit what happened. While there is a growing awareness of SBS among medical practitioners, research by Dr. Carol Jenney at Hasbro Children’s Hospital in Providence, indicates that over 30% of SBS cases are not diagnosed upon the child’s initial hospital or pediatric visit.

Another factor that hindered prevention efforts was the assumption by many professionals was that people must know about the dangers of shaking infants. Studies conducted in 1990 and earlier, however, revealed that perhaps as many as 50% of adults and teenagers do not know that shaking a baby is dangerous. As Dr. John Caffey has stated: " The wide practice of habitual whiplash-shaking for trivial reasons warrants a massive nationwide educational campaign to alert everyone responsible for the welfare of infants..." Clearly, the need for a comprehensive statewide effort to educate parents, caretakers, and professionals about Shaken Baby Syndrome has never been more compelling.