The Tragedy of Shaken Baby Syndrome

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The tragedy of Shaken Baby Syndrome (SBS) has only recently begun to garner public attention. The high-profile trial of British au pair Louise Woodward, who was convicted of involuntary manslaughter for the 1997 shaking death of 8-month-old Matthew Eappen, in Newton, Massachusetts, raised awareness of this little-known form of child abuse. Local advocacy groups continue to spring up around the country, and last year the first-ever National Center on Shaken Baby Syndrome opened its doors in Utah.

SBS is a term used to describe the condition that results from the violent shaking of an infant or small child. "Shaking seems to be a primitive impulse, and it's typically triggered by frustration or anger over a baby's persistent crying," says Robert Reece, M.D., of the Boston-based Massachusetts Society for the Prevention of Cruelty to Children. Studies have found that male caretakers (fathers and boyfriends) are the most likely culprits, followed by mothers and, less frequently, baby-sitters. Experts note that though people are generally reluctant to hit or strike a child, many of them do not perceive shaking to be as harmful an act.

In fact, it is even more dangerous. Babies are vulnerable to injury from shaking because they have weak neck muscles, a large head in proportion to their body, and a brain that has not yet developed myelin, a protective, toughening layer of protein. Consequently, when babies are shaken, the gelatin-like brain knocks back and forth inside the still-roomy skull, incurring serious damage. (SBS most frequently occurs during the first year of life, although children can be seriously hurt at any age).

Unfortunately, it doesn't take more than four or five seconds to injure a tiny brain seriously. "That's enough time for 20 or 30 oscillations of the head," Dr. Reece says. Shaking a baby can cause brain injuries ranging from mild learning disorders to severe retardation, blindness, or paralysis. It's estimated that 20 percent of babies who are violently shaken die. Shaking a baby is very different from playful jostling or bouncing, Dr. Reece emphasizes. "Anyone who witnessed a baby being shaken would describe it as a violent act," he says. "It's very clearly assaultive behavior."

No one knows exactly how many babies are killed or injured as a result of being shaken. The Centers for Disease Control and Prevention, in Atlanta, which compiles mortality figures, does not track this specific kind of child abuse; nor do most county or state health departments. But researchers estimate that as many as 1,400 children die from Shaken Baby Syndrome each year in the United States alone. "And that may be just the tip of the iceberg," says Mark Dias, M.D., a neurosurgeon who has done research on SBS at Children's Hospital of Buffalo.

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