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Questions, tips to prevent shaken-baby syndrome

Suzanne Kreiter/Globe staff

A doll used to teach young mothers about shaken-baby syndrome.

Questions and answers

1. I would never shake my baby. Why should I care about shaken baby syndrome?

No one can imagine ever harming an infant, and parents are even understandably insulted when the topic of violence is raised. However, the American Academy of Pediatrics and other medical specialty boards say these tragedies too often happen -- roughly 1,000 cases of injuries and death a year -- and they typically are unintentional spontaneous reactions to a crying baby who can’t be quieted.

Some pediatricians say this behavior sometimes begins when a caretaker finds that shaking babies, even mildly, startles them and temporarily quiets them, and then begins a series of escalating, dangerous, behaviors when faced with more crying.

Also remember that even if you can’t imagine unintentionally harming a baby, you may put the baby in the care of a friend, relative or babysitter who could, especially if they are impaired through alcohol or drugs, or suffer from anger-management issues.

2. Why do babies sometimes cry for no reason?

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Pediatricians say parents should always investigate troubling causes of infant crying, though sometimes it continues for no apparent reason. Typically infant crying intensifies after the baby passes the two-week mark, and often peaks at six weeks of age. But then sometime between two and four months, babies generally cry less and begin to settle into a more predictable schedule.

The National Center on Shaken Baby Syndrome has a website and a program, the “Period of Purple Crying,” which is devoted to explaining how infants often cry, for long stretches, particularly in the late afternoon and evening.

3. Does playful bouncing of a baby on my knee cause harm?

It’s important for parents to feel comfortable handling and playing with their babies, as infants are resilient and their brains are generally well protected. Gentle bouncing, burping and rocking are safe - and can even help calm babies. It’s key to remember, though, that babies heads are much bigger proportionally to their neck strength and bodies, and parents should handle young infants with care.

Though the public calls this “shaken baby syndrome,” pediatricians prefer the term “abusive head trauma,” which puts the focus on rough handling of the baby’s head, not just shaking. Researchers say the most serious injuries typically come from a combination of shaking and some type of blunt impact on the head, such as a child being thrown to the floor or even a cushioned surface. They believe it is the abrupt acceleration and deceleration of the brain, inside the head, that causes the most severe damage.

3. What about all these defendants accused of shaken baby syndrome going free?

Nationwide, a number of shaken-baby cases have been challenged, some successfully. Some convictions have been vacated, including some due to legal technicalities and others due to new evidence suggesting the baby’s brain swelling and bleeding may be caused by accidents, such as short falls, or natural causes. Still, so far, they represent a small percentage of the total prosecutions involving this form of child abuse.

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A study published last year jointly by the Washington Post and Northwestern University’s Medill Justice Project, identified roughly 1,800 resolved cases nationwide since 2001, of which about 1,600 or nearly 90 percent ended in convictions, which is a higher rate than for other violent crimes. Many included evidence the child suffered bruises and broken bones. They also identified some 200 cases in which charges were dropped or dismissed, or the defendants were acquitted or their convictions overturned.

4. Where can I get more information about this for me -- or others who might care for my baby?

Children’s Trust website includes a video (To access, use the password: abcma)

Massachusetts Citizens for Children has a website and also materials for hospitals, groups and parents.

Source: Local child-abuse pediatricians and child advocacy groups ​