published Wednesday, December 8th, 2010

One moment of anger


by Emily Bregel
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    Staff Photo by Angela Lewis/Chattanooga Times Free Press Annamaria Church, left, and Dr. Karla Garcia speak at T.C. Thompson Children's Hospital on Tuesday about child abuse. The hospital treated six babies in a week who had traumatic brain injuries from being shaken.

During one week in November, six infants were brought to T.C. Thompson Children's Hospital with traumatic brain injuries after being shaken by a caregiver.

Two of the six babies died from their injuries, all of which were identified as child abuse, said Marisa Moyers, coordinator of Erlanger's Safe and Sound program for injury prevention.

Horrified by the "unprecedented" rash of abuse this holiday season, Moyers and other specialists at Erlanger's pediatric hospital want to get a message to parents that one instant of anger can cause lifelong damage to a child.

"Every single case is heart-wrenching," said Dr. Karla Garcia, T.C. Thompson pediatrician, at a Tuesday news conference focused on preventing child abuse. "The parent or caretaker may lose control for a moment or two, but that's all it takes to cause permanent injuries to a child."

Shaking can lead to traumatic brain injuries, formerly referred to as "shaken-baby syndrome," which can cause permanent blindness, hearing loss, learning disabilities, physical handicaps and death, Garcia said.

Prolonged financial pressures are combining with holiday stress to hit families hard this year, with many parents out of work and facing possible expiration of their jobless benefits, Moyers said.

So far this year, 83 children have come to T.C. Thompson with signs of abuse, from limb fractures to burns to sexual abuse. Officials did not have a figure for 2009 on Tuesday.

NATIONWIDE

* 300 — Babies in the U.S. who die each year from shaking

* 1,200 to 1,400 — Babies injured or killed nationwide from shaking

* 80 — Percentage of shaken babies who survive that suffer permanent disability

Source: National Center on Shaken Baby Syndrome

TYPES OF CHILD ABUSE

In 2008, an estimated 772,000 children were victims of maltreatment:

* Neglect — 71.1 percent

* Physical abuse — 16.1 percent

* Sexual abuse — 9.1 percent

* Psychological abuse — 7.3 percent

* Medical neglect — 2.2 percent

* Other (abandonment, congenital drug addiction, etc.) — 9 percent

Source: U.S. Department of Health and Human Services Children's Bureau

T.C. THOMPSON STATS

2009

* Infant patients who had been shaken -- 12

* Total pediatric abuse cases -- unavailable

2010

* Infant patients who had been shaken -- 13

* Total pediatric abuse cases -- 83

Source: Erlanger Health System

RESOURCES FOR CAREGIVERS

* Tennessee Parent Help Line — 800-356-6767

* Children's Advocacy Center of Hamilton County — 423-266-6918

* National Center on Shaken Baby Syndrome — dontshake.org

* Crying awareness site: purplecrying.info

Of them, 13 infants under 6 months old, including the six admitted last month, have had shaking-related injuries, compared to 12 in 2009.

"These are all preventable. This is not something that just happens to children," Moyers said.

The four surviving children with shaking-related injuries have been placed in a safe environment through child protective services, as law enforcement investigates their cases, Garcia said.

Hospital officials — who report signs of abuse to law enforcement, as well as to child protective services — did not know if any arrests had been made in relation to the abuse.

But shaking a baby is a criminal offense, said Sgt. Jerome Halbert, supervisor over family investigations with the Chattanooga Police Department. If there is enough evidence to identify the abuser, police will prosecute in these cases, he said.

Each day, nearly five children die as a result of child abuse, and more than three-quarters are under age 4, according to Childhelp, a national nonprofit focused on preventing child abuse.

Stresses contributing to abuse risk include having multiple young children, single motherhood and problems with drugs or alcohol, Garcia said.

But child abuse transcends economic, social and racial barriers, and anyone can snap in a moment of weakness and escalating frustration, said Annamaria Church, medical director of Erlanger's child protection team.

"It's all levels of society," she said.

Extended crying jags, common among children between 2 weeks and 4 months old, can trigger an exhausted parent to violence, Erlanger officials said.

Some babies wail for up to five hours, regardless of parents' efforts to soothe them, Moyers said.

"[Parents] just don't know what to do, where to go, and they go over the edge for that brief period of time," Moyers said. "Often they're so regretful, but the damage is already done."

An infant crying is the No. 1 trigger for shaking a baby, and shaken-baby syndrome is the leading cause of death in child abuse cases under 6 months, she said.

Shaking kills 300 babies a year, according to the National Center on Shaken Baby Syndrome.

The key is recognizing the trigger and seeking help before losing control, experts say.

Put the baby in its crib and walk away, Garcia said. Call your pediatrician, a friend or the Tennessee Parent Help Line, she said.

"It takes a village to keep these kids safe. If you have friends that have children, then you be there for them, too. It's not easy raising kids in today's society," Moyers said.

Even if a parent has already harmed their child, getting the child treatment can help prevent long-term damage, Garcia said.

"Don't wait because of fear or embarrassment to get your child help," she said.

about Emily Bregel...

Health care reporter Emily Bregel has worked at the Chattanooga Times Free Press since July 2006. She previously covered banking and wrote for the Life section. Emily, a native of Baltimore, Md., earned a bachelor’s degree in American Studies from Columbia University. She received a first-place award for feature writing from the East Tennessee Society of Professional Journalists’ Golden Press Card Contest for a 2009 article about a boy with a congenital heart defect. She ...

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jparker said...

My neices son was one of the children featured in this story. He is a victim of "shaken baby". The justice system, if you can even call it that is allowing this to happen on a daily basis with it's seemingly extreme lack of concern for this. This baby's father, who shook him violenty, was allowed to walk around on the streets for one year plus after the abuse occured. Once it finally came to trial, he plead to a lessor offence and merely got a slap on the wrist with a small jail sentence. Why do these people not get a life sentence for an offense that changes these children's lives for life???? As intelligent as Iverson (the victim) is now, one can only wonder what he would be were it not for the abuse at the hands of his father.

December 8, 2010 at 7:53 a.m.
geolith said...

A study reported earlier this found that there has been a sharp upswing in inflicted head injury during the recent recession. Just like the economic pain, the increase in abuse is abating at an imperceptible rate, if at all.

However, hospital-based prevention education has made a difference. In New York, a prevention program for new parents that began at Children's Hospital of Buffalo in 1998 reduced the incidence of inflicted head injuries by more than 50%.

It requires more than just giving new parents a brochure (TN does have a law requiring hospitals to offer new parents information, eg. a brochure, since 1994).

It requires changing the frame of that education so parents view it not as someone telling them about child abuse ("don't shake your baby"), but as an opportunity for them to learn how to protect their child.

As someone aptly put it, "telling ain't teaching", and parents need to learn how to teach their child's other caregivers about anticipating and coping with the inevitable moments of frustration and anger.

And for those not inclined to learn about the danger of shaking a child and the simple coping skills needed to be a responsible caregiver, they do need to understand that there are serious consequences for losing control.

I hope the folks at Thompson's Children - who deal with the trauma cases - will work with the maternity hospitals in TN to create a positive educational experience for new parents. It's happening in many other states, most recently Kentucky.

April would be a good time to start: for the last five years, Senators Alexander and Dodd have joined on a Senate resolution recognizing the third week of April as Shaken Baby Awareness Week, as have several states.

Birth is the teachable moment. By the time new parents are caught up in the daily challenges of child rearing, less sleep and adjusting to reality of their new life as parent, the opportunity is greatly diminished, if not lost.

And then in the third or fourth month, colic comes...not the best time to learn coping skills (which, when you consider that 10-15% of babies are estimated to develop colic, isn't to say that the overwhelming majority of their parents don't have some amazing abilities to endure inconsolable crying...).

The unfortunate reality is that the new parents who need it most are least likely to read this article.

However, they generally don't avoid the hospital.

George

December 8, 2010 at 7:37 p.m.
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