Project Timeframe: January 2011 – ongoing
Problem: Shaken Baby Syndrome (SBS) describes a set of symptoms found in infants with little or no external evidence of head trauma, including retinal hemorrhages and intracranial hemorrhages with subdural bleeding. Shaken Baby Syndrome is often fatal and can cause severe brain damage, resulting in lifelong disability. Estimated death rates among infants with SBS range from 15% to 38%; the median is 20%–25%. Up to half of deaths related to child abuse are reportedly due to SBS. Nonfatal consequences of SBS include varying degrees of visual impairment (including blindness), motor impairment and cognitive impairment. Risk factors for SBS include: caregivers who may have unrealistic expectations of the child and may display “role reversal” expecting the child to fulfill the needs of the caregiver; substance use and emotional stress; and the risk of aggression and impulsiveness in caregivers. Both males and females can inflict SBS, but the abusers are more often male.
In 2009 Vermont experienced an increase in infant deaths and permanent damage from SBS. This included two deaths of infants in the Brattleboro area.
Goal: To reduce the incidence of SBS through education of parents in risk factors for SBS and coping skills to prevent impulsive behavior resulting in SBS..
Interventions: Using material instituted by Prevent Child Abuse Vermont parents in our Birthing center now view a film “Portrait of Promise” which explains the risks of SBS and the means to mitigate those risks. A Birthing center nurse than reviews with the parents the importance of having a clear safety plan in place when they become frustrated with their crying newborn. The parents are then invited to sign a form, suitable for framing, pledging to their newborn that they are aware of the risks of SBS, understanding their ability to seek help form family and friends as needed, and will advocate for their child’s safety with all caregivers about appropriate safe ways to comfort and cope with a crying baby.
Measures: In 2011 97% of all parents in our Birthing Center signed this pledge.
Results: We will continue to educate new parents in the risks of SBS, and the ways to reduce those risks. We will also continue to gather data on the incidences SBS, and modify our education plan as needed to continue to safeguard the health and safety of children born at BMH.
Michele Rowland, RN, LICSW
Executive Director, Quality, Utilization and Care Management
Brattleboro Memorial Hospital
17 Belmont Avenue, Brattleboro, VT 05301