Health
Little wonder
by Linley Boniface
One or two violent shakes are enough to kill a baby.
Even if you’ve never held a baby, you only have to feel the weight of an infant’s head in your hands to sense how vulnerable it must be.
A baby’s head is large and heavy, yet its neck is weak and floppy. The head feels pliable, and still has the soft spots and flexible sutures that enabled the bones of the skull to mould to the birth canal during delivery. The brain has a high water content, which makes it barely firmer than jelly.
This fragile structure requires such careful handling that even a momentary lapse of judgment can destroy a child’s future. There can be few worse catastrophes for a baby than to be violently shaken. Its head whiplashes back and forth, slamming the brain repeatedly against the skull. There is damage to the brain, bleeding around the brain and possibly bleeding into the back of the eyes.
Babies may momentarily stop breathing, causing further brain damage. Many babies who have been shaken have been squeezed so hard they also have broken ribs. Between 15% and 35% of babies treated this way die, and half of the survivors of shaken baby syndrome are left with permanent brain damage and/or damage to their eyesight.
One or two violent shakes are enough to kill a baby. Some estimates suggest shaking usually lasts for no more than 20 seconds, and in most cases only goes on for between five and 10 seconds.
Although parents often worry about accidentally injuring their babies, normal play – tossing a baby in the air, bouncing it on a knee or pushing it vigorously on a swing – doesn’t cause the same types of injuries as shaken baby syndrome.
New Zealand does not have great statistics on abuse of the under-twos. Government agencies such as the police, hospitals and Child, Youth and Family (CYF) tend to collect different information, use different definitions of abuse and have different ways of coding and reporting abuse. So, although we know that about 23 children each year are hospitalised after being shaken, no one can be certain of the full extent of the problem.
Parents or caregivers are most likely to shake their baby out of frustration, often triggered by a baby’s crying. It’s no coincidence that shaken baby syndrome is most common around between the age of six weeks and four months, when babies cry the most.
A disproportionate amount of abuse of babies is carried out by men. Children’s Commissioner John Angus says men who have shaken a baby tend to have problems with drugs, alcohol and managing their anger. “Families need to think very hard about who’s caring for vulnerable young babies, and what sort of support they’re getting,” he says.
In August, ACC released figures suggesting that lifetime care for a baby with a head injury such as shaken baby syndrome could be as high as $20 million. Sometimes, babies seem to recover well, but they have learning difficulties that hinder their school work or make it hard for them to look after themselves as teenagers and adults.
Earlier this month, Social Development Minister Paula Bennett launched a series of initiatives aimed at cutting the abuse figures. The initiatives include a “Never Shake a Baby” awareness campaign, support for an Auckland District Health Board pilot programme to give new parents information about shaken baby syndrome before they leave hospital, basing CYF social workers in more hospitals, better monitoring systems and a plan to protect abused children after their release from hospital.
Angus, who is chairing a new forum of independent experts to advise the Government on child-abuse programmes, says the whole community has a part in play in preventing shaken baby syndrome and other forms of abuse.
In one case Angus was told about by a social worker, a woman was concerned about how the single mother living
next door was treating her three preschoolers. The woman considered calling CYF, but instead approached her neighbour and offered to help. Eventually, the mother came over to the woman’s house with her older boy, who sat at the kitchen bench drinking Milo while they talked.
“Now, the mother feels she’s able to ask her neighbour for help. And when the oldest boy sees his mum getting frantic, he climbs through a hole in the fence to the neighbour’s house and calls out to his mum, ‘I’m just going over to see Mrs Milo,’” says Angus. “Patterns of violence that lead to abuse can take a while to get established, and sometimes neighbours can step in to break the cycle.”
