Crying, especially inconsolable crying, is the most common trigger for shaking and physical abuse of infants. A new research program may provide parents and other caretakers the tools they need to prevent shaken baby syndrome (SBS), a form of child abuse that can cause immediate damage to the victim's brain or be fatal. The National Center on SBS reports that crying, is the most common trigger for shaking and physical abuse.
The Doris Duke Charitable Foundation, New York City, has donated $1.2 million and the George S. and Dolores Dore Eccles Foundation, Salt Lake City, Utah, has donated $300,000 to fund the research. The program is designed to reduce shaking and abuse of infants by changing the knowledge, attitudes and behaviors of parents and other caretakers about early infant crying, shaking and abuse.
The program funded by the Duke and Eccles Foundations is called the Period of PURPLE Crying. It is designed to change the knowledge and behavior of every parent, and to provide health care practitioners with the knowledge, skills and materials to simply, quickly and effectively educate parents about infant crying and thus reduce frustration and stress that leads to shaking and infant abuse.
Parents participating in the project will receive uniquely designed information about crying, as well as a magnet, bib and video about understanding and coping with crying. Parents will also receive a daily diary to complete, which tracks their baby's crying and steps they have taken regarding that crying.
The acronym PURPLE describes the behavioral characteristics that normal babies go through and that can be very frustrating to parents and caretakers. These behaviors, even in babies with colic in almost every case, will come to an end at about four months. Each of the letters of the word PURPLE refers to one of these characteristics:
P - Peak of Crying--Crying peaks during the second month, decreasing after that;
U - Unexpected--Crying comes and goes unexpectedly, for no apparent reason;
R - Resists Soothing--Crying continues despite all soothing efforts by caregivers;
P - Pain-like Face--Infants look like they are in pain, even when they are not;
L - Long Lasting--Crying can go on for 30-40 minutes, and longer;
E - Evening Crying--Crying occurs more in the late afternoon and evening.
"The National Center on SBS, headquartered in Utah, is partnering with leading institutions and expert investigators to test and implement the program”, said Marilyn Sandberg, executive director. The Center will work with Dr. Fred Rivara of the Harborview Injury Prevention and Research Center (HIPRC), Dr. Ronald G. Barr of the University of British Columbia, and consultants at the University of California, Berkeley School of Public Health.
The HIPRC was largely responsible for the research on bicycle helmets for children, which resulted in a decrease of brain injury by as much as 88 percent. "The bike helmet story is a wonderful example of systematically tackling a problem and making a large impact around the country,"says Rivara. "Bike helmet use is now standard for most children and their parents. This same expertise would be applied to the problem of SBS. This project will bring together the resources to accomplish a national program to prevent shaken baby syndrome.”
"Parents who would never consider hitting their baby become frustrated with the continual crying to the point that they shake him or her,"explains Barr. "If the shaking is mild, there may be no external signs of harm. However, the shaking may stun and quiet the baby temporarily. This makes the parent think the shaking stopped the crying and that no harm was done.”
Barr reports that the age when babies begin to increase their crying (two weeks) is the same age infants begin to be hospitalized for SBS, and the increase and then decrease in crying amounts are reflected in increases and decreases of hospitalizations for SBS. The peak age of SBS hospitalizations is slightly later than the peak age of crying, probably because many cases are the result of repeated shakings.
The research program has begun and will run through 2007. If proven effective, it will be replicated throughout the U.S. and Canada. The mission of the Doris Duke Charitable Foundation, the primary donor for the project, is to improve the quality of people's lives through grants supporting the performing arts, wildlife conservation, medical research and the prevention of child maltreatment, and through preservation of the cultural and environmental legacy of Doris Duke's properties. More information about the foundation can be found at www.ddcf.org