Shake Martinis but Not the Baby
17 Mar 2005
What do I know about babies? Not much, and that’s why I rarely write about babies. But I recently learned a devastating fact about them. James Bond always insisted that his martinis had to be shaken. But a report in The Medical Post shows that shaking a crying baby can be lethal. But who caused the brain damage? The parents or the baby sitter?
Dr. Ron Barr, a British Columbia pediatrician, is Director of the British Columbia Research Institute for Children’s and Women’s Health, in Vancouver. He recently presented shocking evidence on the extent of injury to shaken babies at a medical meeting in Montreal.
Barr told doctors that studies show the incidence of shaken babies is 30 per 100,000 per year. This is higher than the worst suicide rates in the world! In fact, this number may be just the tip of the iceberg. After all, what parent wants to admit they’ve caused brain damage by shaking their baby? Besides many cases of brain injury never come to medical attention.
Shaking a baby tosses its brain back and forth rupturing veins causing hemorrhage. The result is that 25 percent of these babies die and the rest suffer from permanent neurological effects such as blindness, cerebral palsy, development problems and learning disabilities.
It’s ordinary people and often baby-sitters who shake crying babies. The shaker may be tricked into believing that because the baby calms down it has learned a lesson. In fact, if the shaking works they may shake the baby again and again to stop the crying. But they fail to realize what may have stopped the crying is a brain concussion!
Dr. Barr stresses that crying must be considered a normal reaction like sleeping. And that when extreme crying occurs, all too often the cause is labelled as due to colic. 98 percent of the time this diagnosis is wrong. So no one should go on a wild goose chase to adjust formulas. Bluntly, every parent must get it out of their head that the baby has a tummy ache.
So here’s Dr. Barr’s vital message, "If the baby is crying with no other physical symptoms such as diarrhea, or weight loss, then it is just crying." And sometimes the proper move is to put the baby down and walk away. As a non-pediatric expert that advice sounds sensible to me.
Barr calls this baby reaction "PURPLE" crying. Its peak time is the first few months of life. It’s unpredictable, resistant to soothing, the face indicates pain, the crying bouts last up to three hours and commonly occur in the evening.
Dr. Jean-Claude Decarie, a Quebec pediatric neuroradiologist at Ste Justine Hospital, says that if a baby is brought to Emergency drowsy and vomiting doctors are always suspicious it may be due to the shaken baby syndrome.
Solving what has happened requires more than the enquiring eye of a Sherlock Holmes. But today modern imaging technology helps radiologists decide if the baby has been shaken causing brain injury. A membrane is present that separates the left and right side of the brain. If an infant’s CT scan is taken soon after the shaking incident and fresh blood is seen along the sides of this membrane it is highly suggestive of brain injury which leads to brain loss.
Dr. Decarie sees up to eight cases of the shaken baby syndrome every month. He adds that he has only heard of one case in which a woman admitted shaking the baby. Rather, parents only confess after radiological evidence proves what has happened.
So who shook the baby, the parents or the baby-sitter? This question isn’t easy to answer. Dr. Decarie says that although symptoms appear at an early stage it’s still not possible to time the injury by a CT scan to show who was the guilty party.
Dr. Barr and Decarie report that the number of cases of shaken baby syndrome is on the rise. They blame it on the various pressures of our society. I would add the sad fact that today when so many unmarried teenagers are suddenly forced to care for a screaming baby something has to give.
My advice, pick your baby-sitter well and have her read this column.
