Shaken babies, shattered lives
PATRICK, 6 months old, Boston; Natalie, 5 months, Brockton; Josh, 3 months, Dracut; Theresa, 2 months, Worcester; Harry, 4 months, Framingham; Jack, 1 month, Holyoke; Adam, 2 months, Leominster; Melissa, 3 months, Lynn; Frank, 6 months, Brighton; Heather, 3 months, Rockport; Michael, 2 months, Holden; Patricia, 1 month, Springfield. . .
These are some of the nearly 80 Massachusetts children, according to a recent report by the Department of Social Services, who were killed or injured from 2001 to 2004 after being shaken by a parent or caregiver. Since shaken baby syndrome is often undetected and misdiagnosed, these names and numbers tell only a partial story. According to the American Academy of Pediatrics, inflicted brain injury is the No. 1 way infants are killed in our country. Shaking a baby, usually in response to infant crying or fussiness, is the most frequent cause.
Sadly, nearly a third of children who are injured from being shaken die as a result. Those who do survive can suffer lifelong consequences including brain damage, blindness, hearing loss, and mental retardation. Medical costs can reach $1 million in the first three years after a serious incident. According to the Brain Injury Association of Massachusetts, rehabilitation and custodial care for a survivor can range from $4 million to $9 million in lifetime costs. Legal and law enforcement expenses, child welfare and special education costs add to the price tag -- about 60 percent of which is borne by state programs.
Yet these injuries, and the expenses that follow them, can be prevented. For that to happen, we need to understand how often shaken baby syndrome occurs -- and work with healthcare workers and parents to stop it .
Nearly one-third of cases in the United States are not diagnosed at the first hospital or pediatric visit following a shaking incident, according to research by pediatrician Dr. Carole Jenny. In a study of 173 children injured by shaking, over one-fourth of those not diagnosed were injured again. As a result, 40 had complications that could have been avoided, and four died because of lack of diagnosis.
Fortunately, such incidents are not inevitable. Educating parents of newborns about the dangers of shaking reduces the incidence of the syndrome by nearly half, according to one recent study. Teaching parents and caregivers skills to successfully soothe infant crying, such as those promoted by pediatrician Dr. Harvey Karp, would go a long way to reduce the syndrome and other forms of physical abuse.
Public health leaders and child advocates stand ready to implement tested plans to reduce these preventable tragedies. Here in Massachusetts, an initiative to prevent shaken baby syndrome has been underway in Worcester County for over three years involving hospitals, regional offices of the Departments of Public Health, Social Services, Early Care and Education, as well as the district attorney's office and many private agencies. With support from the Health Foundation of Central Massachusetts, the program has educated hundreds of healthcare providers and other professionals.
An in-hospital program operating in the county's birthing hospitals has educated more than 250 nurses about shaken baby syndrome and its prevention. These nurses have in turn educated more than 5,000 parents of newborns. Surveys show that 83 percent of parents shared the information with their children's other caregivers. Of parents who reported their babies had been crying or fussing a lot during the first three months, 94 percent reported that the training helped. Over 8 percent called the statewide Parental Stress Line as they had been encouraged to do for support .
Policy leaders have taken notice. Several months ago, Beacon Hill legislators listened to heart-wrenching testimony as parents described their once healthy babies now dead or disabled. Many that day, including legislators, were moved to tears at the senseless loss of life.
Within days Massachusetts is expected to pass the most comprehensive shaken baby prevention legislation in the country. It will direct the Department of Public Health to collaborate with other agencies to implement a statewide initiative. Many features being proposed have already been piloted in Worcester County .
With resolve, legislators and advocates have achieved an important victory . If the bill's provisions are implemented, some children who might have died or been injured will be spared.
Jetta Bernier is executive director of Massachusetts Citizens for Children and directs its SBS Prevention Center. Harry Spence is commissioner of the state Department of Social Services. 
