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There Is Never a Good Reason to Shake a Baby

Dr. James King, Chief of the Children’s Hospital of Eastern Ontario’s (CHEO) Division of Pediatric Medicine, and other colleagues, recently published an article which concludes that Shaken Baby Syndrome has an extremely high degree of mortality and that the ongoing care of these children places a large burden on the medical system, caregivers and society.

The term “Shaken Baby Syndrome (SBS)” is used to describe an extremely serious form of abusive head injury resulting from shaking an infant or young child. When a baby is briskly shaken, the head moves back and forth. This motion causes tearing of the nerves and blood vessels in the brain which results in bleeding inside the head and pressure on the brain. A baby’s head and neck muscles are not completely developed and brain tissue is very fragile. Shaking a baby or child even for a few seconds can have lifetime consequences such as behavioural or learning difficulties.

Dr. King and fellow researchers looked at charts from 11 children’s hospitals across the country. In a 10-year period, from 1988 to 1998, 364 children with SBS were identified. Twenty-eight of those were at CHEO. Nearly 20% of these children died, 55% had lasting neurological injury and 65% had visual impairment. Most were under 6 months of age and ranged from seven days to just over four years. These children required long-term multi-disciplinary medical care, specialized education, adaptive housing, vocational training and the involvement of child welfare authorities.

It is estimated that a minimum of 40 cases of SBS occur annually in Canada, of which 8 children will die, a further 18 will have permanent neurological injury requiring life-long assistance and 17 will be taken into foster care. Sadly, the study acknowledges that the number of SBS cases they looked at represents only “the tip of the iceberg” as many cases of SBS go unreported, are unknown and clouded in secrecy.

There is no doubt that caring for children can be demanding and trying even at the best of times. “Parents, partners and caregivers need to seek help from a trusted friend, partner, family member, nurse, doctor or community health organization when they feel overwhelmed.” said Dr. King. “What’s important to remember is that if help is not immediately available, make sure your child’s basic needs are met, that he/she is not hungry or needs changing, place the child in his/her crib or bed, close the door and leave the room for 5 minutes and check back periodically. There’s nothing wrong with doing that. As long as the child is in a safe place, you’ll be able to calm down and regain your composure.”

Dr. King and his colleagues hope that this study will encourage discussion and action in terms of creating a national strategy to establish the incidence of SBS, identify vulnerable children, and develop and evaluate prevention strategies.

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