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.
* 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
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
* Infant patients who had been shaken -- 12
* Total pediatric abuse cases -- unavailable
* Infant patients who had been shaken -- 13
* Total pediatric abuse cases -- 83
Source: Erlanger Health System
* 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.