The Tragedy of Shaken Baby Syndrome
It doesn't take more than four or five seconds to injure a tiny brain seriously, and as many as 1,400 babies die each year from this devastating form of child abuse. Skipper Lithco was one of them.
Peggy Whalen had no reason to think anything was wrong when she left her job on a crisp afternoon last November and headed toward the baby-sitter's house to pick up her son. Her husband, George Lithco, an attorney, had dropped off George "Skipper" Lithco about six hours earlier, just as he'd been doing five days a week for the past six weeks. The 11-month-old baby had been bright-eyed and bubbly when he waved bye-bye to his dad.
As Peggy, a 40-year-old elementary schoolteacher in Poughkeepsie, New York, approached the baby-sitter's home, she noticed police cars and emergency vehicles parked at the end of the road. When she got out of the car and a paramedic addressed her by name, she realized that something terrible had happened. "He told me Skipper had had a febrile seizure and had left minutes before in an ambulance," she says. "My heart started pounding. I was terrified."
At the hospital, she found her son in critical condition in the emergency room. "They were doing tests and wouldn't let me in to see him right away, but I could hear him crying," Peggy says. "At that point, the nurses still thought he'd had a seizure, so they said crying was a good sign." George, 51, arrived shortly afterward. "By then, Skipper was only semiconscious," he says.
The baby's condition continued to deteriorate, and he was transferred by helicopter to Westchester Medical Center, a large research hospital in a neighboring county. There, doctors performed a CAT scan, confirming that the baby's brain was swollen and bleeding. They told his parents there was only one likely explanation for such injuries: Skipper had been violently shaken, which had caused his still-fragile brain to slam against his skull. "We didn't believe it," Peggy says. "There was just no way that he'd been with anyone who could have done that."
As they sat by their son's bedside, Peggy and George desperately tried to think of other possible scenarios. Skipper had just started walking; perhaps he had fallen and hit his head. Another child the sitter cared for, a 2-year-old, liked pulling their son around in a small red wagon. Maybe it had tipped, causing Skipper to fall out and hit his head. The parents even asked the doctors to investigate whether the baby's injuries could have been the result of some undiagnosed genetic problem. "But when we suggested other possibilities, the doctors were skeptical," Peggy says.
George and Peggy's anguish was compounded when investigators from Child Protective Services arrived to interview them about Skipper -- a routine procedure in cases of suspected child abuse. "I understood why they needed to treat us with such suspicion, but it made the whole thing even worse," Peggy says.
Meanwhile, the Poughkeepsie police talked to baby-sitter Lynn Matthews, the 51-year-old woman who had been taking care of Skipper. Initially, Matthews denied doing anything that could have hurt the baby, but detectives weren't convinced, and they persisted. Upon further questioning, she admitted that she had grown frustrated with Skipper's crying that afternoon and had picked up the 23-pound child and violently shaken him until he quieted down.
Skipper remained unconscious and on life support through the weekend. Sadly, there was nothing the hospital staff could do. He was pronounced dead at 5:25 p.m. on Sunday -- just three weeks before he would have turned 1. "I had so many dreams and wishes about how we would celebrate Skipper's first birthday," his father remembers. "I never thought that we'd be taking a cupcake, a candle, and a dozen blue balloons to a cold and windy cemetery."
More Cases Reported
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.
A Random Act
The most chilling aspect of SBS is just how randomly it can occur -- a fact starkly illustrated by what happened to Skipper Lithco. "I've gone over it in my head a million times," Peggy says. "I keep asking myself if there was anything to indicate that this kind of thing could happen, any clue I missed, and I can honestly say there wasn't."
The new parents had been more than conscientious about finding child care for Skipper when Peggy decided to resume teaching after her maternity leave. Lynn Matthews, whom Peggy found through a classified ad in a local newspaper, seemed ideal. She'd raised children of her own, had four grandchildren, and had been watching kids in her home on and off for the past ten years. When Peggy and George met her, she was taking care of her 2-year-old grandson and was soon to take another toddler into the home she shared with her daughter and son-in-law. The couple interviewed Matthews for almost two hours, and their initial impression was that she was loving, caring, and enjoyed being around kids.
"She seemed very gentle, and Skipper took to her right away," George recalls. Peggy telephoned her two references, "and both of them gave the sitter unqualified praise," she says. "There was nothing at all that raised a red flag."The first week Skipper spent with Matthews, George's sister spent a day helping the baby get acclimated to his new surroundings. George and Peggy routinely stayed at the house for half an hour or so when they dropped Skipper off or picked him up.
No one is certain exactly what happened on November 30, 2000, the day that Skipper was fatally shaken. According to police, Lynn Matthews reported that the baby had been crying a lot that afternoon. The two other toddlers were coming down with colds and may have been cranky. At about 3:30 p.m., after being fed, Skipper spit up. "Matthews apparently grew frustrated, lost control, and began shaking the baby," says Detective Frederick Jankowski, one of the police officers who investigated the case. "Afterward, when she realized he was slipping out of consciousness, she called EMS."
Lynn Matthews knew at the time she shook Skipper that the action could have potentially fatal consequences, according to Marjorie Smith, an assistant district attorney for Dutchess County, who prosecuted the case. The sit-ter admitted she was familiar with the risks of SBS and that she had just "lost it" that day with Skipper. "Matthews may not have been intending to kill the baby, but she was aware of the danger and she disregarded it," Smith says.
In April, Matthews pleaded guilty to second-degree manslaughter and is currently serving a 3 1/3- to 10-year sentence in a maximum-security women's prison. Neither she nor her attorney responded to repeated requests for an interview by Parents. But in court transcripts, the baby-sitter expressed remorse for her actions. When she found out that Skipper had died, it was as if someone had "pulled my heart out of my chest and stomped on it," she said. "I am tortured daily by what happened. I can only hope that the Lithcos have some measure of peace knowing that I will always bear this horrible pain."
Out of Grief, Advocacy
If there is a glimmer of hope in the story of Skipper Lithco, it is that his death will raise awareness of SBS and, if his parents have their wish, ultimately help prevent other children from suffering the same tragic fate.
Shortly after Skipper's funeral, members of a mothers' group that Peggy had belonged to organized a public-education campaign called the Skipper Initiative. They've set up a Website and printed brochures on ways to deal with the frustration brought on by a crying child, alerting people to the dangers of SBS.
Peggy and George, though still overcome with sadness, anger, and disbelief, are trying to channel their grief into advocacy. They were active lobbyists for a law passed in August by the New York state legislature that requires hospitals to tell all new parents -- either in person or via a brochure or a video -- about the dangers of shaking a baby.
One of the messages that Peggy and George hope to convey is that feeling overwhelmed by a crying baby is nothing to be ashamed of. Peggy still aches every time she thinks about what Lynn Matthews could have done when she grew frustrated with Skipper. "She could have put him down and walked out of the room for a breather," Peggy says. "She could have called George or me and said, 'You need to come get Skipper now.' She could have just let him cry. She knew I would have been there within the hour."
As the first anniversary of Skipper's death approaches, Peggy and George still struggle to come to terms with their grief. Peggy sees a counselor once a week to help deal with her anger and depression. But she and her husband cherish the wonderful memories of their time with their son. Pictures of Skipper fill the living room, and Peggy and George have yet to clear everything from his nursery. "Skipper was so full of promise and potential," his mother says as she shows a visitor a videotape of the precious moments of Skipper's life. There he is, sitting in his high chair scooping up Cheerios, playing peekaboo with Daddy, holding onto his mommy's hands as he takes his first tentative steps.
Slowly, Peggy is beginning to look toward the future. She and George would like to have another child, she says. They both loved being parents more than anything else they'd ever done. But they know that even another child will never fill the emptiness they feel. "When we lost Skipper, we lost the center of our universe," Peggy says. "No matter what the future holds, we will never again experience the pure joy we felt when he came into our lives."
Coping with a Crying Baby
Advocates emphasize that feeling unable to cope with a crying child is not a sign of bad parenting but rather an indication that the caregiver needs relief. Here's what doctors suggest for anyone who feels overwhelmed by an inconsolable baby.
- STOP Put the baby in a safe place, such as a crib or a playpen, and let her be. There is nothing unsafe or abusive about allowing a baby to cry for five or ten minutes.
- TAKE A BREATHER Walk into another room where the crying isn't quite so loud. Sit down for a moment,and take ten slow, deep breaths.
- GET RELIEF Check that the baby's physical needs have been met (her diaper is dry, she's not hungry, her temperature is comfortable). If you cannot calm the child, ask a friend or a relative to come help you.
- The Shaken Baby Alliance, www.shakenbaby.com
- National Center on Shaken Baby Syndrome, www.dontshake.com
- Shaken Baby Syndrome Prevention Plus, www.sbsplus.com
- Skipper Initiative, www.skippervigil.com
- The Shaken Baby Alliance
- The National Center on Shaken Baby Syndrome
- SBS Prevention Plus
- The Skipper Initiative