August 15th, 2008
02:25 PM ET
Shaken baby tragedy
By Dr. Sanjay Gupta
A few years ago, a woman called me in the middle of the night to tell me her son-in-law had been taken to jail. This was a woman I knew pretty well, and I was stunned to hear the story she proceeded to tell me. Her grandchild (his daughter) had been found unconscious at the house and taken to the hospital. Doctors there quickly figured out the child had been shaken. Just a few months old, her little neck muscles had not been strong enough to stabilize her head, which in young children is relatively bigger with respect to their bodies. She developed a blood collection on her brain and shearing of small blood vessels deep inside. Ultimately, she never recovered; she died in her mother’s arms. The little girl’s dad had been the only one in the home and subsequently admitted to handling the child in a rough manner when she was persistently crying.
In a moment of anger, he had killed his child and essentially sentenced himself to imprisonment. As a dad, I can’t imagine the incredible grief he is still suffering today, so many years later. As a neurosurgeon, I have seen this story play out more times than I care to remember.
It is of little value to say that he didn’t mean it. He is a good man who made a terrible mistake. It did make me wonder, though, just how much are young parents equipped to be able to deal with babies and very young children. Most parents are shocked when I tell them the consequences of shaking a baby or handling the child in a rough manner. Add in a little immaturity, lack of necessary patience, and you literally have a prescription for disaster.
As you can read today (link to story), there are some relatively simple ways to prevent a fatal mistake. But, should we be doing more?
There are no instruction manuals when it comes to children, as there are with most other things in life.
Should there be a sort of “manual” and what sort of things should be in it? What would you put in a manual that goes home with new parents?
Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.
About this blog
Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.
There is really no support in place for new parents, once they leave the hospital. In the UK, new mothers are visited at home by midwives, and are able to give very specific advice and help in each individual situation. .
As a mother of 3 I know how difficult the first weeks with a newborn are. It's hard to remember what we learnt in prenatal classes, sleep deprivation, problems with nursing, colic. Peidatritions tend to give standard answers but an equally professional consultation AT HOME specific to my baby would have been invaluable.
At the end of the day it is money – who would pay for such a service?, I think that my health insurace should cover it, but that is another problem in itself.
What matters most to new parents of any age is support. Sleep deprivation turns all of us into a shell of our former selves. Add in the pain of common childbirth-related medical conditions such as a c-section or mastitus, and the seemingly irrational crying of a baby who has already been fed and burped and has a clean diaper, and you have a volatile situation that is bound to send even stable parents off the deep end sometimes. And that scenario doesn't even include a toddler or another needy child in the mix.
We used to have a society where generations were close by and supported one another. These days, there just aren't enough hands to help when a situation becomes too stressful. I look at that father and I thank God that I never got to that point when my children were young (and crying), but I can remember that overwhelming feeling. It is a fine line that all parents walk between putting the baby in the crib and taking a 5 minute break in another room, and going off the deep end with a life-altering mistake.
Dr. Gupta, I'm 29 years old and I don't have children, but I have been a pre-school teacher, nanny, camp counselor, and long time babysitter when I was younger. I was a pre-school teacher in Atlanta for one year and I have to say, that was the hardest job I will ever have in my life. But it taught me patience in addition to lots of other things. 19 one to two year old's running around isn't so easy! I would put in that "manual" that you HAVE GOT to have experience with kids before you have a kid. The reason I say this is because it was sort of sad that many of the parents in my class had no experience with children before they had their own, and it was weird, because they would ask me what to do with their kid. I was only 22! I can tell you for a fact that I know children way better than most of my friends with babies because I had those experiences with all those kids in the past, and sometimes, I find myself giving them advice. Also, being a teacher was the best form of birth control I've ever had!!! I would recommend that to anyone thinking about having a kid!
I have always felt that parenting classes should be a requirement as early as junior high. In a society that is as progressive as ours, it is incomprehensible to me that parenting classes are not required. In fact, I've never heard debate/discussion on the subject.
No one adequately communicates what the first three months will be like to new parents. Everyone talks about how cute babies are and how much fun they will be. They talk about changing diapers, burping, feeding, etc. They say, "don't shake the baby", but you're thinking "why would i shake the baby? That seems dumb, who would shake the baby?"
Here's the reality. The first three months (for some) is an utterly miserable time, you don't get any sleep, the baby screams for hours, and it can sometimes push you to the brink of losing your sanity. There, i said it, parenting is not a beautiful thing that's all fun and games. It's not just an inconvienince, it's not just annoying, it pushes you to the brink. In some cases it pushes people over the edge because they don't let themselves put the baby down and walk away. Believe me, after three months of having no more than an hour of uninterrupted sleep at a time with a total of 4 or 5 hours sleep in a day and a baby crying for 3+ hours every evening for absolutly no reason, i think anyone can shake a baby. This isn't someone annoyed by a baby and deciding to shake them, this is someone with a sleep deprived brain that's chemically messed up that has a breakdown. I've experienced it and had to walk away leaving the baby cry for a few minutes. My wife experienced it and walked away crying herself because she felt that she was doing something wrong by walking away from a crying baby.
What we need is some sort of national backup care where new parents can call and have someone else come at a moments notice and watch their baby for a few hours so they can get some sleep and recover. I live >3000 miles from my nearest relative, it was just me and my wife tag teaming the baby and trading off sleep time. I'm lucky because i got a month of paid paternity leave to help out and share the burden.
I'm just glad our son is over 4 months old now, sleeping through the night most nights, and no longer screaming for hours without reason. It's amazing how colic seems to just disappear at around 4 months old.
i agree with some of the prior comments.
i am a single mother of a son. i have not experienced the same conditions that some families face where babies are inconsolable, crying alot, colic-y, etc. I did not face that, nor did i face a situation where i was raising multiple children. So, my heart and prayers are absolutely with those whose who do face the more challenging experiences – praise to the parents of large familes, praise to the single mothers/fathers of multiple children, praise to those raising children who are challenged. I am not an expert on any level, nor am i commenting or passing judgement on anyone.
i am very worried about the situations parents face where children are inconsolable and are ultimately harmed or worse. is this a societal issue to address? I don't know. do mothers and fathers need to be more educated before rearing children? i don't know. if so, what is that cost to society? is that fair to society as a whole? if the answer to those questions is no, what is the consequence to those mothers/fathers with no support system?
this is a huge problem for our society as a whole and i am so sad to see the problem continue...i don't know the answer but i do know this issue needs more attention
I think there should be more of an official support agency that you can call no matter what the hour whenever you are in a situation where you don't know what to do. Like in France they will send someone to your house, free of charge to show you how to take care of a baby as long as you need them to.
Anger is such a strong emotional trait that we all wish wasn't a part of the human characteristic make-up. It really take a powerful, strong moment to stop and take a deep breath in the mist of an anger outburst. If you know you are quick to fly off the handle in a moments notice; Then I think you should practice daily, to stop and count to ten, followed by deep breaths. This practice will help in those split seconds when you feel overwhelmed and out of control. I've been there, done that. This is the voice of experience talking.
I came so close to injuring my screaming baby, that it still makes me shake today, 25 years later. Why? Because I believed that you should never, ever allow a baby to sleep in bed with you, and that babies need to be taught to "cry it out". Well "cry it out" turned into incessant screaming in between one or two hours of actual sleep. After 3 weeks of this, I was so sleep deprived I was hallucinating. Finally, I brought him in bed with us and we all slept. He slept with us until he was a year and a half, and transitioned beautifully into his own bed. Crying it out it does not work for all babies and should not be presented as though it will. Co sleeping is a viable alternative.
My older sister was Jiggled and rolled as a baby, tossed up in the air and caught for her own entertainment, but ended up with crossed eyes. My baby sister was rolled pretty hard by us older kids because it made her laugh, and I dropped her when she was 3 months old. She also ended up with crossed eyes.
We have a huge family, including cousins, siblings, aunts & uncles. Those 2 were the only ones with crossed eyes. Both needed surgical correction.
As an adult, I have become active in volunteering for an ambliopia early intervention program. I have learned that what we do to make the baby laugh is often times too rough. Unfortunately, the kind of person who would shake a baby is not the kind of person who reads Dr. Gupta blogs, so I feel that this information needs to be taken to the streets and not just the internet.
Oh please – enough of the excuses. I was a difficult baby in that I was one of those who would cry for hours for no reason once I got started. It was so bad that the police were called on my mother twice because the neighbors thought she was abusing me. My father was the only one who worked while my mother took care of me and my brother. I'm sure both were sleep deprived and without any family to help they did not shake me etc. They took me to the doctor and explained the problem so I was prescribed some medication. My father fed it to me once and then told my mom that it might damage my vocal cords later on so they threw it away and just let me scream my head offf until I grew past it. Being a parent is not easy and we laugh about it now that I'm grown. Point is -don't have kids if you don't have patience.
When I had children my mother gave me some valuable advice, and I heard her voice in my head many times when I was fed up with the kids. She told me to never try to deal with them in anger, if you are very stressed, tired or angry, seperate yourself from your child, if they're older send them to their room, if they're an infant, put them in their crib. Go sit down and take a deep breath and relax, step outside for a few minutes if they're screaming their heads off. But give yourself time to settle down and let the anger subside, then go to your child and take care of them. This advice helped me get through some tough times.
There is no good reason to shake an infant–ever.
Any adult human who does not have the good common sense to not shake an infant whose nervous system and spinal cord are clearly immature–deserves whatever befalls them. My hope–what befalls them is rapid, severe, and uncompromising.
Well From my experience males do have a supper hard time when it comes to understanding babies. I am a mother of four children all under the age of five and im only 21. i feel if you can not handle the responsibility then get some one who will help. there thousands of people who have relationships and can't have children. i bet that night that child was crying some one who had the wright mind would of figured the baby out. if the mother knew he didn't understand the baby, she should of never left them alone.
Sounds to me as if all these people we are sending to jail for killing of injuring babies need to be reevaluated as to whether their "attack" was premeditated or not. Most will come back as they never intended to injure the child, just to get them to quiet down or stop.
They don't really need punishment. They need training and rehabilitation. They sure as heck don't get that in prison.
I have a three month old son and he loves to fall asleep on my legs while I bounce my knees. I am very away of the shaken baby syndrome especially since I have seen several cases while being in the health profession. After watching the clip of the “Shaken baby tragedy”, I starting thinking that I might be doing some damage. Is there a problem with me bouncing my knee while my son lays on my legs and falls asleep?
I was disappointed that you did not mention a new prevention program called "The Period of PURPLE crying" in the piece you did about Shaken Baby Syndrome. The National Center on Shaken Baby Syndrome to which you referred has information about this program. PURPLE is the acronym that describes the characteristics of normal infant crying in the first few months of life than can be so frustrating. It would be a wonderful service and a great opportunity for you to disseminate information about this program through your HOUSE CALL program. If parents and the rest of society understood the normalcy of crying in the first few months of life it would decrease the frustration level and possibly prevent someone from going over that threshold to shaking a baby. Learning about ways of coping with this crying and the importance of walking away and never leaving a child with someone who has a low frustration tolerance are all ways that we as a society can hep prevent this tragedy from occuring.
Thank you for highlighting this public health issue and please consider supplementing it with information about the PURPLE prevention program. It is being adopted in my state of North Carolina and it is hoped to decrease the incidence of SBS by at least 50% in the next 5 years. It's not enough to tell parents about the dangers of shaking. We must approach this problem from a more positive angle and this is one way to do it. You can help. Thanks so much.
I was one of the lucky ones, my mother was here when my son was born, and consoled me and him when he cried. She taught me about colic, and about giving him gripe water which is a natural remedy to ease the pain. Thankfully he grew out of it in about 3-4 months. There are several natural remedies that are available at any large health food store that is not taught at the classes that are offered on infant care at the hospitals.
I have two children and my first cried for 8 1/2 months from colic, he cried so much he missed several milestones. I did not have help. But I will say NEVER in a million years did hurting him cross my mind. I think our society is filled with ill people and when they are under stress is when you see their SICKNESS surface. The human race is a mess, it is sad. Students need parenting classes in high school and anything else to help them be productive in our Society. It seems we do everything possible to sabotage people when they become adults. Our prison system is filled with lost causes, and it doesn't make sense how they have full medical care on death row but a law abiding citizen can be denied medicine or surgery if they don't have insurance. It is sad children are hurt by pedophiles and judges let them back on the street again not even caring about the next victim. In the state of New Jersey, Politicians hire their family members to work for them, give them high salaries, free pensions, health insurance, nobody cares the Federal Government lets them steal from the tax payers, break the law.
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