Program aims to reduce shaken baby syndrome

Julie Robbins with her 9-month-old son, Daniel.
John Clarke Russ | BDN
Julie Robbins with her 9-month-old son, Daniel.
By Meg Haskell, BDN Staff
Posted April 18, 2011, at 12:57 p.m.

BANGOR, Maine — A new baby. Expectant parents typically conjure up visions of an angelic little sleeper, silly bath times and that magical first smile.

But what many new parents don’t expect is that their cozy little bundle of joy may actually turn into a howling, hiccuping, inconsolable bundle of misery for hours at a time, day after day, night after sleepless night, month after endless month.

When their best efforts fail to calm their infant, exhausted new parents may feel overwhelmed, guilty — and desperate.

“No one wakes up and says, ‘I think I’ll hurt my baby today,’” says Dr. Amy Movius, a pediatric intensive care doctor at Eastern Maine Medical Center in Bangor. But even the best parents can lose their cool when their baby simply cannot be comforted, she said, and the result can be tragic.

Shaken baby syndrome — also known as abusive brain trauma — occurs when a frustrated adult shakes a tiny infant in an effort to quiet him or her. The quick action jars the baby’s developing brain, tearing vital blood vessels and slamming the fragile brain against the bone of the skull. The resultant injury can be severe and permanent, leading to a lifetime of mental retardation and physical disability. Some injuries are severe enough to cause death.

Movius, who cares for these heartbreaking cases in EMMC’s neonatal intensive care unit, says all new parents need to learn about “the period of purple crying” — the first six months of life, when a perfectly healthy baby may challenge parents’ creativity, patience and stamina with prolonged episodes of intense crying.

Thanks to a coordinated effort among hospitals, physicians and social service agencies, Maine recently became one of just a few states to adopt a consistent, statewide program to help frazzled parents cope with a baby who just won’t stop crying.

At every Maine hospital where babies are born, along with knowing how to change a diaper and install a car seat, new parents now are asked to demonstrate familiarity with “The Period of Purple Crying” — a 10-minute video with accompanying educational materials — before leaving the hospital with their new baby.

The video, produced and marketed by the Utah-based National Center on Shaken Baby Syndrome, delivers a few key points to new parents. Among them:

  1. Crying — even in prolonged episodes — is normal behavior in babies.
  2. It is not always possible to soothe a crying baby, although parents should try.
  3. It won’t last forever. Babies typically outgrow their crying jags by the time they are 6 or 8 months old.
  4. Parents and other caregivers who feel their frustration rising after trying to calm a crying baby should lay their infant in a crib or other safe place and just walk away, for up to 10 minutes, or until they feel calm enough to deal patiently with the baby again.
  5. Parents should not leave their babies in the care of people who are inexperienced, short-tempered or under significant stress.

Babies often start kicking up a fuss around their second week of life and may cry for three or five hours a day, often in the evenings, Movius said, when everyone is tired anyway. Crying may intensify through the fifth or sixth month of life and then, blessedly, it typically tapers off.

These crying babies are not hungry or sick, Movius said. They don’t need their diaper changed and they’re not in pain. They’re just crying, a lot. Parents who reach the end of the ropes need to know it’s OK to leave their crying baby in a safe place for a few minutes while they step outside, call a friend, brew a cup of tea and generally collect themselves, she said.

“The only thing you can do wrong is lose your cool and hurt your baby,” Movius said.

Julie Robbins of Bangor hardly qualifies as a “new mother,” since she has two teenage daughters, neither of whom was a particularly cranky baby.  But when the 43-year-old gave birth last winter to Daniel, now an engaging and easygoing 9-month-old, she says, she and her husband Carl were pleased to be shown the video and provided with other information about shaken baby syndrome before leaving the hospital.

“I thought it was great,” Robbins said. “It really gets you to think about what am I going to do if I ever find myself going down the path of total frustration where I might actually do something that would harm my child.”

Fortunately, Daniel has been a real cream-puff of a baby, and Robbins’ two daughters enjoy taking care of their baby brother when their parents go out.

“He’s our treasure,” Robbins said.

In addition to watching the “Period of Purple Crying” video before taking their babies home, Maine parents should be hearing consistent messages from their pediatricians, home health visitors and others in the social service network.

Dr. Lawrence Ricci, a pediatrician who specializes in cases of child abuse at the Portland-based Spurwink agency for children, said the incidence of shaken baby syndrome diagnosed in Maine hospitals is low and in keeping with national rates.

“The average is that we see four or five cases a year,” he said. But in 2008 and 2009, the state saw a “huge spike” — two or three times as many cases as normal, he said, adding that many, many more cases than that go undiagnosed each year. That increase in completely preventable tragedies prompted the statewide response, Ricci said, and hopes are high that the “Period of Purple Crying” program will make a difference.

Because every parent is only human, shaken baby syndrome crosses all socioeconomic lines. But the condition is more common in families that are already stressed by poverty, substance abuse, criminal activity and domestic violence. It is most often the baby’s father or another male in the home who causes the injury. Babysitters and other caregivers are also more likely to shake a crying infant than is the baby’s mother, Ricci said.

Funding for the statewide Period of Purple Crying initiative is patched together by individual hospitals, private foundations and individual donations.

For more information, visit the National Center on Shaken Baby Syndrome at  http://www.dontshake.org/

http://bangordailynews.com/2011/04/18/health/program-aims-reduce-shaken-baby-syndrome-by-explaining-%e2%80%98period-of-purple-crying%e2%80%99/ printed on December 20, 2014