Preventing Shaken Baby Syndrome

   Darryl Gibbs’ cherished 8-month-old daughter, Cynthia, was shaken to death by her New York State-certified childcare provider on November 17, 2000.  To honor Cynthia’s memory, Gibbs, a Yonkers resident who is founder of the Cynthia Gibbs Foundation and parent spokesperson for the National Center on Shaken Baby Syndrome, has devoted himself to educating the community-at-large about shaken baby syndrome and how to prevent this form of child abuse. His educational outreach includes parents of newborns, childcare providers, and school students. “I didn’t even know about shaken baby syndrome when my daughter was killed. There was no training back then,” Gibbs recalls.

   Four years later, in September 2004, an SBS educational and prevention program called the Hudson Valley Shaken Baby Prevention Initiative (HVSBPI) was founded. The HVSBPI currently involves 22 hospitals with maternity services in the lower Hudson Valley; its aim is to educate parents of newborns about SBS while their babies are still in the hospital.

   Shaken Baby Syndrome (SBS) is the name given to the injuries that occur when a child is violently shaken.  Many incidents of SBS occur when a parent or caregiver responds in frustration to a constantly crying child.

   In just a few moments of aggressive shaking, a young child’s health can be severely compromised.  The child might suffer blindness, memory or learning deficits, paralysis, mental retardation, or seizures.  The child could also be left in a persistent vegetative state, or could die.

   Dr. Herschel R. Lessin, nationally recognized pediatrician and medical director of Children’s Medical Group, with seven offices throughout the Hudson Valley, explains in layman’s terms why infants are especially susceptible to SBS: “The head is the biggest part of the infant’s body and the brain hasn’t grown into the size of the head, so there is a big space between the brain and skull.  When shaken, the infant’s head stops, but the brain keeps moving and hits into the skull.  This can bruise or injure the brain.”

   According to Dr. Lessin, there are two other factors that make babies vulnerable to SBS. The blood vessels of a baby’s brain are not well attached and shaking can tear these vessels.  In addition, an infant has weak neck muscles that are not able to support the head well, so shaking causes a whiplash effect.

   Infants are not the only ones affected by SBS; the syndrome has been documented in children as old as 5 years of age. “Shaking is more likely to cause serious injuries in children aged 2 and younger, but it can happen at any age,” Dr. Lessin says.

   The symptoms exhibited by a child who has been shaken differ in severity.  A child with a mild shaking injury might be lethargic, irritable, display a decreased appetite, or seem excessively sleepy.  A more severely injured child might have difficulty breathing, bleeding in the eyes, vomiting, seizures, or a loss of consciousness.  If the parents observe these symptoms and suspect that the child has been shaken, it is vital to seek medical attention immediately and to share their suspicions with medical personnel.

   Parents should think twice before playing too rigorously with their child, Dr. Lessin warns, saying, “The younger the kid, the less vigorous the parent should be with play, especially with children under 4 months.”

   Annually, there are 1,200 to 1,400 cases of SBS, and one in four injured children dies. Christine Deyss, executive director of Prevent Child Abuse New York, reports, “Seventy-five percent of perpetrators are the parents, and 60 percent are the fathers or father figures,” but cautions about over-reliance on statistics, as SBS sometimes presents as some other kind of injury. In addition, a recent study in Pediatrics found that young children who live in a household with unrelated adults are nearly 50 times more likely to die from inflicted injuries such as SBS.   

Education is key to prevention

   Dr. Robin Altman, chief of general pediatrics at Maria Fareri Children’s Hospital at Westchester Medical Center in Valhalla, spearheads the HVSBPI. “We educate 25,000 parents of newborns annually,” she says. The program has been successful in reducing the number of SBS injuries in the area, according to Dr. Altman.  “Prior to the program, three cases of shaken baby syndrome a year were referred to Westchester Medical Center. In the first 18 months of the program, no cases have been referred.”

   Maria Fareri parents are offered literature about SBS and are given the opportunity to view a short video, Portrait of Promise, which features three families who speak about how SBS has impacted their lives. In the film, nationally renowned child abuse expert, Dr. Carolyn Levitt, offers an explanation of SBS and tips for prevention. Before leaving the hospital, the parents are asked to sign a statement that says they understand the danger of shaking a baby and that they agree to share this knowledge with others.

   A second phase of the HVSBPI is to distribute an SBS informational card to pediatricians and family care physicians. The card will then be given to parents before their child reaches 2 months of age. The timing of this gift is well considered because, as Dr. Altman explains, the peak incidence of SBS occurs when infants are between the ages of 2 and 4 months.

   This year, the HVSBPI will begin to offer a lullaby CD, Together We Can Dream, through pediatricians’ offices. The CD contains original music written and performed by Laurie Parks, the music therapist at Maria Fareri. It includes soothing music, a bedtime story, and a guided relaxation exercise for the parent. Suggestions for dealing with a crying child and a toll-free Parent Helpline telephone number are included with the CD.

   Soon after the tragic death of his daughter, Darryl Gibbs contacted his state representative and worked to have a bill added to the New York State social services law. The law now requires all New York State childcare providers to receive SBS training. Gibbs has been visiting over 500 certified childcare workers in Westchester to teach them about SBS prevention. “We want to teach the childcare providers not to take it personally when the child cries,” he says.

   Gibbs advises parents to employ certified childcare workers who have SBS training and to keep the lines of communication open. “You want the childcare provider to be open if they don’t feel up to caring for your child that day,” Gibbs said. “We want healthy babies.”

   In September, Gibbs will initiate an SBS educational program as part of the Yonkers schools’ health curriculum. He explains that students should know about SBS because they might babysit for younger siblings or neighborhood children. The information will also serve them well when they become parents.

   A baby who cries non-stop can be aggravating. However, there are strategies to release stress and overcome feelings of rage. “Never pick up a baby when you are frustrated,” Gibbs advises.

Resources
American Academy of Pediatrics: www.aap.org

Prevent Child Abuse NY in Albany: 518-445-1273 or 1-800-342-7472; http://preventchildabuseny.org

The National Center on Shaken Baby Syndrome:1-888-273-0071; www.dontshake.com

Shaken Baby Alliance: 1-877-636-3727; www.shakenbaby.com

SKIPPER Initiative: 1-845-297-4779; www.skippervigil.com

When Baby Won’t Stop Crying

   In December 2000, 11-month-old George “Skipper” Lithco was shaken to death by his childcare provider. To honor his son, George Lithco of Dutchess County founded the SKIPPER Initiative, an SBS education and prevention organization. Kim Albea, a member of the SKIPPER Initiative, offers the following tips for handling a crying infant:

Make sure the baby’s basic needs are met.

If the baby continues to cry and the parent feels frustrated, take a brief break.

—Watch television.