Preventing Shaken Baby Syndrome

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Preventing Shaken Baby Syndrome
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OBJECTIVES

• Description of Child and Family Resource Council
  and its programs
• Discuss the causes and outcomes of Shaken Baby
  Syndrome
• Share relevant research regarding prevention
• Discuss coping strategies for the caregiver
• Learn calming strategies for the infant

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• The Councils Mission
• To shape a community that protects
• children from abuse and neglect.

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• History
• The Council was formed in 1985 as a means to
  proactively deal with child abuse and neglect in
  Kent County. Since the beginning, the Council
  has utilized primary and secondary prevention
  strategies to accomplish its goals.
• Why prevention?
• The Councils programs and services are provided
  before problems arise. In other words, while
  other organizations focus on treating the effects
  of child abuse and neglect, we work to stop abuse
  and neglect from ever happening.

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Council Programs and Services

• Connections Offers helpful information about
  your childs development, parenting tips, and
  ideas for fun activities to do with your child.
• Community Education Educational services and
  trainings such as Mandated Reporter Training,
  Shaken Baby Syndrome Prevention, parenting
  education, and other topics to help prevent child
  abuse and neglect.
• Encouraging Family Foundations Provides a
  series of parenting and life skills classes to
  unmarried parents of children 0-2 years old.

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Programs and Services (continued)

• Family Resource Guide Comprehensive,
  easy-to-use directory of over 900 programs,
  services and resources available to children and
  families in Kent County.
• Kent County Healthy Start Provides support for
  first-time parents through home visitation, phone
  calls, and information.
• RAVE (Resources Against Violent Encounters)
  Using the In Touch With Teens program and peer
  education, RAVE helps prevent adolescent
  relationship violence by facilitating interactive
  presentations around developing healthy
  relationships.

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Prevention Saves More Than Lives

• In 2002, direct costs related to child abuse and
  neglect in Michigan totaled 1,783,926,271
• The cost of prevention services is less than
  three percent of intervention costs
• One quarter of children from abusive households
  will require special education services

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What Is Shaken Baby Syndrome (SBS)?

• A unique form of inflicted intracranial injury
• Caused by rotational acceleration/deceleration
  forces
• Directly causes brain, head, eye, and spinal
  injuries
• Is sometimes called AHT (Abusive Head Trauma)
• Can be deadly
• Shaken Baby Syndrome IS child abuse

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SBS Stats

• Head Trauma is the leading cause of death and
  permanent disability among young, abused
  children. Shaking is a contributing factor in
  many of these cases.
• True incidence of SBS is unknown. National
  estimates range from 600 -1500/year. (1400
  20/100,000 children.)
• Michigan 50 -100 cases/yr.
• 65 of the offenders are male (mostly biological
  fathers and live-in boyfriends of the mother)

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SBS Stats (continued)

• Common offenders of SBS
• Fathers 45
• Babysitters 18
• Moms live-in boyfriend 17.5
• Moms 13.5
• Others (ex. Step-parents) 6

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SBS Stats (continued)

• Average age of the victim is 7 months (most from
  birth to 3 years of age, but SBS can occur at any
  age).
• 10 - 40 of the victims die as a result
• Nationally 10 - 40
• Locally 10 - 15
• 80 - 90 of survivors are developmentally
  handicapped.
• Approximately one-third of SBS cases are missed
  the first time by medical professionals.
• One study found that 1/3 of the U.S. population
  had not heard of SBS.

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What Makes Infants Vulnerable to SBS?

• Large head babys head 25 of body weight,
  Adults 13
• Weak, underdeveloped muscles in neck
• Greater amount of space between the brain and
  skull
• Immature brain softer skull
• Immature, fragile blood vessels (bridging veins
  between brain and skull)

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Possible Signs of SBS

• Breathing difficulty
• Bruises on the shoulders, neck or around the
  upper portion of arms, rib area or back (be aware
  that adults bruise easier than babies)
  Lethargy/decreased muscle tone
• Decreased appetite or vomiting for no apparent
  reason
• Extreme irritability
• Seizures/posturing
• If SBS is suspected, seek immediate medical help.

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Potential Consequences of SBS

• Auditory impairments deafness
• Behavioral Disorders
• Broken/fractured ribs
• Cerebral Palsy
• Convulsions/Seizures
• Death
• Developmental Delays
• Emotional Impairment

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Potential Consequences of SBS cont.

• Mental Retardation
• Paralysis
• Rigidity or Posturing
• Severe Motor Dysfunction
• Visual impairments and blindness (retinal
  hemorrhages)

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Remember

• SBS is caused by abusive forces
• External signs of trauma are often absent
  however, neurological symptoms can start
  immediately in severe cases
• Rib fractures are strong evidence for abusive
  force
• The name SBS is controversial in some circles,
  but whatever it is called, the catastrophic
  damage caused by it is still the same
• The only cure is prevention

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Why Does SBS Happen?

• Inconsolable Crying
• Is the Leading Reason
• That a Baby
• Is Shaken.

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Video

• Portrait of Promise

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Why Do Babies Cry? (Some Theories)
1. Colic

• 1 in 5 babies in the U.S. have repeated bouts of
  terrible fussiness for no apparent reason -1
  million a year in the U.S.
• Many other cultures never have colicky babies

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2. The Period of PURPLE Crying

• Peak of crying (around 2 months)
• Unpredictable (often happens for no apparent
  reason)
• Resistant to soothing
• Pain-like expression on babys face (even without
  any obvious source of pain)
• Long bouts of crying (lasts 30-40 minutes or
  more)
• Evening crying is common in fact, the witching
  hour is a scientifically proven fact.

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PURPLE Crying (continued)

• Proposes that periods of inconsolable crying are
  normal and may even be helpful
• Some children cry more (20 are the colic
  group) its really a variation on human behavior
• Increased contact with PURPLE infants is
  encouraged (can be up to 50 effective)
• National Center on SBS and researcher Dr. Ronald
  Barr have begun a 3-year study on educating
  parents (2004-2007)
• Focus is on parents needing help in riding it out

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3. The Missing Fourth Trimester

• Belief that newborn is still a fetus
• Evidence Brain size increases 20 and gains in
  complexity and organization in first 3 months
• All babies have a calming reflex related to their
  time in the womb
• Many babies are able to adapt quickly however,
  some babies may need the 3 months to
  imitate/continue conditions in the womb

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No Matter What the Reason, When An Infant Cries

• He/she is too young to understand requests
• He/she may be crying to relieve tension
• Just because it is nighttime, does not mean a
  baby turns off (they are on their own schedule)
• Decide that you are there to help the baby, not
  necessarily to stop him/her from crying

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Successful, Positive Strategies to Calm a Crying
Infant (and the caregiver)
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1. Check Basic Needs

• Hungry? Feed him slowly
• Gassy? Burp her
• Wet? Change his diaper
• Too hot or cold? Adjust clothing
• Lonely? Pick him up
• Check for signs of illness
• Check for signs of gas/colic
• Be creative in trying different calming ideas

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2. Check the Caregiver

• When caregivers are tired/frustrated, they are at
  higher risk for losing control
• It is natural to feel frustrated when crying
  occurs
• Choosing options for dealing with the crying is
  not as easy to think of at that point

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Caregivers (continued)

• Should choose a positive coping strategy in
  advance
• Make sure their needs are being met too
• Should never be caring for more children than
  they can handle
• Should ask for help
• If nothing seems to be working, put baby in a
  safe place and take a break
• Calm down and then try again

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3. Tried and True Methods

• Additional warmth
• A warmed blanket (careful)!
• Hat
• Socks
• Warm bath
• Body massage
• Develop a support system

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Tried and True Methods (continued)

• Exercise
• Hand child to partner/other person
• Listen to music
• Talk to someone on the phone
• Take a hot shower
• Read a book
• Walks outside
• Watch TV

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4. The Cuddle Cure

• Found in Dr. Harvey Karps Book The Happiest Baby
  on the Block
• Proposes the Cuddle Cure
• (a.k.a. The 5 Ss)

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The 5 Ss

• Swaddling (provides feeling of Pure Wrapture)
• Side/Stomach lying (Babys feel good position)
  Only when awake
• Shhhing (Babys favorite soothing sound)
• Swinging (Rock-a-bye baby)
• Bed is disorienting and unnatural
• Breaks into babys crying cycle
• Sucking (the icing on the cake)
• Keeps the calming reflex on

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The 5 Ss (continued)

• The 5 Ss are based on our ability to turn off
  babys alarm switch and allow the calming reflex
  to work (car alarm)
• Reflex can only be triggered by more vigorous
  movements and handling (in-utero movements)
• May not work right away. There is lots of chaos
  in the brain babies can be slow to absorb and
  they have cycles of crying

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Will These Strategies Spoil the Baby?

• NO!!!
• During the first three months, the brain not
  organized enough to be spoiled
• These strategies provides babies with confidence
  and resiliency
• Quick responses and consistency actually creates
  less fussy and more patient children at age one
• Our job is to nurture babys confidence in us and
  the world around them

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Remember

• Shaken Baby Syndrome is 100 preventable
• Every child that is shaken is a life that is
  lost, whether to death or to significant
  long-term disabilities. SBS has tremendous
  physical, emotional, medical and economic impacts
• Education works One study demonstrated a 57
  decreased incidence of SBS over 3 years when
  parents received education post-partum.
• For more information, check out the website for
  the National Center on Shaken Baby Syndrome
  www.dontshake.com

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For more information, contact the Council at
616.454.4673 or look at our website
www.childresource.cc

• THANK YOU FOR COMING!