Shaken Baby Syndrome and National Awareness - Literature review Example

Shaken Baby Syndrome and National Awareness Ten years ago a disturbing case broke out in public via the televised trial court of a shaken-baby case involving a British nanny named Louise Woodward of the death of Matthew Eappen in 1997. The case brought public awareness about this complex known as Shaken Baby Syndrome or SBS (Levenson, 2005). Definition. According to Dr. Robert Reece of Tufts University School of Medicine, Shaken Baby Syndrome is the medical term describing the numerous signs and symptoms of an infant being violently shaken that created an impact in the head (National Center on Shaken Baby Syndrome, 2007). Accordingly, the possible amount or degree of the damage to the brain it could acquire depends upon the forces and the duration of the shaking or related violent causes. Research shows that 20% of incidences are fatal after a few days of the injury occurred, while the majority of the survivors are left with several related disabilities (National Center on Shaken Baby Syndrome, 2007). Most common of these disabilities include mental and developmental retardation, blindness, vegetative state, learning disorders and epilepsy (National Center on Shaken Baby Syndrome). For example, Christian Joseph Dubisky, a victim of Shaken Baby Syndrome, acquired the disease when he was just four months old when he was shook by his father, but survived for few years with such inconvenience, and died in the young age of seven. Diagnosis upon Dubisky included damaged cognitive area, retinal detachment, intermittent gag reflex, inability to eat, osteoporosis, thyroid disorder, and epilepsy (Christian's Shaken Baby, 2007). To Dr. John Lancon of National Center on Shaken Baby Syndrome (NCSBS, 2001), SBS is the constellation of intentional intracranial and ocular hemorrhages occurring in infants and young children. Some quarters believe these are what caused Christian Dubisky's death, although it is said not all the time will the case include hematoma and brain hemorrhage that are the main cause of possible death of the victims (NCSBS, 2001). Description. Anatomical attributes contribute the susceptibility of an infant for brain damage from SBS. Accordingly, infants with bigger heads, weaker neck and shoulder are prone to the syndrome (Patel & Moorjani, 2005). The violent shaking or any act of cerebral movement disturbance can cause blood vessels inside the brain and behind the eyes to tear and bleed (HealthLink Alberta, 2006). The syndrome was first described in the medical literature in 1972 where it was reported that 50,000 children in the United States are forcefully shaken by their incapable caretakers every year (Thivierge, 2006). The report said some 60% of this population were boys, because of being hyper in crying, and victims aged from six to eight months old. Statistics reported that most of the responsible culprits of the cause of the syndrome are men than women by shaking a child. Mostly women who committed such violence are caretakers or any distant relative of the victims. The common reason for such act is seen as being impatient to the inconsolable cry of the infant which is common to babies, and also an action of abuse as a sign of psychological disturbance of the suspect (Thivierge, 2006). Causes. Shaken Baby Syndrome or SBS is usually caused by non-accidental trauma or intentional child abuse. It is commonly caused by anger or frustration on the part of the caregiver as a response to the baby's persistent crying (PennState Children's Hospital, 2007). Infants' or babies' heads are more fragile compared to those of adults; their brains are underdeveloped, and neck and muscles are weak, and these are supposed to be supported. The younger the child, the more he is likely to develop SBS, but victims can reach up to the age of five years. It is said that even a few seconds of violent shaking may cause an infant lasting brain damage or even die (HealthLink Alberta, 2006). Van Vhoorees (2006) claimed that shaken baby syndrome or SBS does not easily conclude from gentle bouncing, playful swinging or tossing the child in the air, or jogging with the child. According to him, short falls from high places, such as accidentally falling from the chair and the like, may result in other infant head injuries but are often minor Symptoms. It is to be noted that a baby, when shook, may not result in any visible symptom even though severe damage has occurred within the brain. Internal bleeding within the area inside the skull may cause the brain to swell (NOAH, 1999). In the process, if the swollen brain reached the skull, nerves and continental brain, damage may occur. By these, damages can cause serious problems such as inability to see, to hear, cause vegetative state, speech impairment, mental retardation, learning disabilities, and death (NOAH, 1999). Cerebral Edema or swelling of the brain caused by accumulation of fluid, is also common in a severe case of shaking (NOAH, 1999). Outside physical signs are also apparent but are not usually acknowledged in the syndrome, such as rib fracture, and signs of trauma like bruising, swelling, and bleeding (Van Vhoorees, 2006). Symptoms of the syndrome in these mentioned damages are extreme irritability, lethargy, sleepiness, poor feeding, decreased alertness, loss of consciousness, pale or bluish skin, vomiting, convulsion, and not breathing as inability to function by the respiratory organ Eye bleeding behind the retina is also one of the vital signs of the syndrome (Van Vhoorees, 2006). Diagnosis. It is often difficult to diagnose Shaken Baby Syndrome as there might not be any witness if the act even took place. An infant may look like normal after the act, and signs cannot be seen immediately. In most common cases, babies are often diagnosed with different medical disorders (NOAH, 1999). Doctors usually handling the case cannot rely alone on the parents' reasons for certain occurrence of symptoms. They usually check retinal bleeding as any signs of physical abuse, and such bleeding may be from violent shaking, as it easily breaks the blood vessels at the back of the eye (NOAH, 1999). Lately, some research institutes challenged the belief of other practicing doctors for easily diagnosing Shaken Baby Syndrome with the bleeding of the eye of an infant. Wake Forest University contests the idea of the retinal bleeding as instantly a sign of physical abuse according to recent reports. The research team of the University conducted a study of the retinal bleeding cases, and found out that there are instances that are caused by accidents (BBC, "Doubt over," 2004). Treatment. Amy Fackler (2005) said the best way to aid the immediate effect of a baby being shaken is to seek medical attention. Observations need to be done in order to know the proper kind of treatment as it is important for doctors to see any signs of brain swelling and difficulty in breathing as early signs of the syndrome. When finally diagnosed with SBS, the infant needs to be confined in Intensive Care Unit, for oxygen therapy treatment (Fackler, 2005). It is the neurosurgeons who take care of the bleeding and swelling of the brain, the internal and the external injuries, and severe cases needing surgery (Health-Cares.Net, 2007). Meanwhile, the behavioral therapist takes care of the behavioral effect from the injury. In addition to these, vision, speech, physical therapy, and special learning services, are needed for the further development of an infant who had acquired and survived SBS (Health-Cares.Net, 2007). The treatment depends upon the severity of the acquired injuries. There are cases of mild injuries acquired and it was observed that mild injuries could heal overnight (NOAH, 1999). Prognosis. Meanwhile, the prognosis in Shaken Baby Syndrome is usually poor. There have been cases where infants were diagnosed with different medical disorders, and die because of mistreatment. Severe cases may result in the infants' long-term acquired damages that will stay with them all through out their lives (NOAH, 1999). Blindness, mental retardation, loss of motor control may also be permanent. However, rehabilitation can help an infant to cope with the new disability caused by injuries (NOAH, 1999). Prevention. Shaken Baby Syndrome, as being primarily the result of reckless handling of an infant by an adult, is preventable. Awareness about the syndrome and the cause of it will serve as primary step of prevention. It is but natural for infants to cry, even to the extent of inconsolable crying, and parents or guardians should know about this, as this is sometimes what causes a guardian to get impatient (NeuroSurgeryToday.Org, 2007). Concerned institutions researching about Shaken Baby Syndrome suggest an educational awareness and nursing support program in every community. The syndrome may be just so recent for the public to be aware, and just recently it is officially termed. However, the diagnosed related disabilities of the syndrome already exist. It is just that the public is not aware yet (Ward, Bennet & King, 2000). In the area of education as prevention, a personal check on every parent and guardian about their capability to take care of a baby should always be considered at first hand (NeuroSurgeryToday.Org, 2005). Psychological fitness is also to be considered before attending to the infant's needs. Awareness about the danger of shaking the baby due to reasons such as to suppress the inconsolable cry is very important so that every parent and guardian should be educated on this (NeuroSurgeryToday.Org, 2005). Simple exercises may be helpful to veer a guardian away from doing abusive acts toward an infant. Taking a deep breath from 1 to 10, and giving time for a baby's cry would be some of these. A safer step is to immediately call a pediatrician during its inconsolable cry to know the reason for a baby's inconvenient condition. (Ward, Bennet & King, 2000). Every parent and guardian should be instructed even in these practical matters. Guardians, during the baby's incessant cry, should place the baby on the crib or playpen, and then leave the room in order to calm down when impatience begins to set. Soothing the child may proceed if the guardian is already calm (Health-Cares.Net, 2007). A warm bottle, a dry diaper, a soft music, a bath, or a play might be what the baby wanted all along. If the crying persists it may be an indication of pain or illness, and medical attention may be needed in this situation (Health-Cares.Net, 2007). These should be part of the fundamental feed to every parent and guardian. The Law and SBS. For all the furor over SBS, Senator Bradley Byrne initiated a law for the prevention of Shaken Baby Syndrome (SB 35, "Shaken Baby," 2007) The bill required certain hospitals and birthing centers to provide a specialization for the study and care of Shaken Baby Syndrome. Section 2 of the law requires that "Every hospital and birthing center which has maternity and newborn services shall provide to the parents of a newborn, before they take their newborn home from the hospital or birthing center, written information on Shaken Baby Syndrome." (SB35, "Shaken Baby" 2007). Read for the third time and passed as amended on March 13, 2007, the law doesn't provide yet certain punishment for the culprit of the act of shaking. However, suspects are charged with physical abuse of minor and granted the respective punishment within the charge, and severe cases may turn the charges into murder if the victim died. References BBC News. Doubt over shaken baby diagnosis. Last updated March 26, 2004. Retrieved September 9, 2007, from http://news.bbc.co.uk/2/hi/health/3564605.stm. Christian's Shaken Baby. Retrieved September 9, 2007, from http://www.geocities.com/shaken_baby_us/ Fackler, Amy (2005). Topic Overview: Shaken Baby Syndrome. Palo Alto Medical Foundation Interactive Page. Retrieved September 7, 2007 from http://www.pamf.org/health/healthinfo/index.cfmA=C&hwid=hw169815 Health-Cares. Net (2007). What's the treatment for shaken baby syndrome. Retrieved September 9, 2007 from http://neurology.health-cares.net/shaken-baby-syndrome-treatment.php HealthLink Alberta (2006). Your Health: Shaken Baby Syndrome. Retrieved September 07, 2007 from http://www.healthlinkalberta.ca/Topic.aspGUID=%7B8B047337-2F31-44F2-9B02-1F12FAAFD32F%7D Levenson, M. (2005). Lawmakers target shaken baby syndrome. The Boston Globe. September 5, 2007 from http://www.boston.com/news/local/articles/2005/10/27/lawmakers_target_shaken_baby_syndrome/ National Center on Shaken Baby Syndrome (NCSBS) (2001). Medical Facts: Shaken Baby Syndrome. Retrieved September 5, 2007 from http://www.dontshake.com/Audience.aspxcategoryID=8&PageName=MedicalFactsAnswers.htm NeuroSurgeryToday.Org (2005). Shaken Baby Syndrome. Retrieved September 7, 2007 from http://www.neurosurgerytoday.org/what/patient_e/shaken.asp New York Online Access to Health (NOAH) (1999). Shaken Baby Syndrome Forum. Retrieved September 6, 2007 from http://www.faqs.org/health/Sick-V4/Shaken-Baby-Syndrome.html Patel, N. & Moorjani, B. (2005). Neonatal Injuries in Child Abuse. E-Medicine Web MD. Retrieved September 9, 2007 from http://www.emedicine.com/neuro/topic238.htm Pennstate Children's Hospital: Shaken Baby Syndrome. Retrieved September 8, 2007 from http://www.hmc.psu.edu/childrens/healthinfo/s/shakenbaby.htm SB35. By Senator Byrne. Senate. . Legislature of Alabama. [A bill to be entitled an act. To require certain hospitals and birthing centers to provide written information to parents regarding Shaken Baby Syndrome. Read for the third time and passed as amended. March 13, 2007]. Thivierge, Bethany (2002). Shaken Baby Syndrome. Health A to Z. Retrieved September 6, 2007 from http://www.healthatoz.com/healthatoz/Atoz/common/standard/transform.jsprequestURI=/healthatoz/Atoz/ency/shaken_baby_syndrome.jsp Van Vhoorees, Benjamin (2006). Medical Encyclopedia: Shaken Baby Syndrome. Medline Plus. Ward, M.G.K., Bennet, S. & King, W.J. (2000). Prevention of Shaken Baby Syndrome: Never Shake a Baby. Official Journal of Canadian Pediatrics Society. Read More