April 27, 2009

Shaken Baby Syndrome Renamed

The American Academy of Pediatrics is encouraging doctors to adopt a more scientifically descriptive term for shaken baby syndrome.

The group suggests a term - such as "abusive head trauma" - which communicates diagnosis of brain, skull and spinal injuries associated with shaking as well as other head injuries experienced, to be issued in a policy statement being published in the May issue of its journal, Pediatrics.

The academy says that the use of the new diagnostic term in medical records could provide more clarity in the courtroom where some defense attorneys and doctors are able to claim that shaken baby syndrome doesn't exist on the grounds that unless the neck is broken, it is not plausible for a baby to be shaken hard enough to cause brain damage.

Dr. Robert Block, former chairman of an academy committee on child abuse explains that this argument is based on faulty evidence and most physicians who specialize in treating child abuse would differ.

Shaking can cause bruising, swelling, and bleeding, "which can lead to permanent, severe brain damage or death," according to The National Institutes of Health.

Block says that avoiding the use of such a vague term such as "shaken baby syndrome" could curb legal rhetorical maneuvering which distracts from the question of whether the abuse actually occurred.

Block, a pediatrics professor at the University of Oklahoma's community medicine school in Tulsa, explicitly expresses that when it comes to the possibility of death resulting from shaking an infant, this change of terms in no way alters the position of the academy.

Dr. Cindy Christian, a co-author of the policy statement and a child abuse researcher at Children's Hospital of Philadelphia, said evidence indicates that while it is possible for babies to be injured by severe shaking alone, many times they also have head injuries caused by other abuse.

The National Center on Shaken Baby Syndrome says shaking ends in injury or being killed in an estimated 1,200 to 1,400 U.S. children each year, but with many cases unreported, this number is likely much higher.

While the new term, "abusive head trauma", is broadly used, the advocacy group states that shaking is in fact the particular leading cause of death in most cases.

Marilyn Barr, executive director of the center on shaken baby syndrome, commends the academy for "trying to clear murky waters."

The policy encourages doctors to look for signs of head trauma that could be the result of shaking and to educate parents about more effective ways to calm a baby and avoid the dangers of shaking.


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