Most new mothers and fathers in Buffalo and Western New York don’t leave the hospital without a sobering lesson: Don’t under any circumstances shake your baby. That message as well as advice on how to cope with a crying infant is delivered to them via a short video, a leaflet and posters hanging in the maternity ward.
The warning apparently has been heeded. Deaths from Shaken Baby Syndrome have decreased significantly in the Western New York region since the program began in December 1998.
“People know they’re not supposed to shake a baby. Our premise is not that we need to educate people,” said pediatric neurosurgeon Mark S. Dias, MD, who originated the program. “We believe that people need to be reminded of the danger at the right time-when they’re holding their baby in their arms for one of the first times.”
Dr. Dias, formerly chief of pediatric neurosurgery at Children’s Hospital in Buffalo, began and expanded the program with a small amount of money, without creating new materials or compromising his other neurosurgical commitments. Yet the Shaken Baby Syndrome project has potentially saved lives and millions of dollars (considering the care for a shaken baby can easily top $1 million).
“My friend, Michael Partington, [a neurosurgeon in St. Paul, Minn.], told me that I could save more lives with this program than I might in my entire career as a neurosurgeon. That’s incredible,”said Dr. Dias.
Inspired by Personal Experience
Dr. Dias was inspired to begin the program following his own frustrations in calming his infant son. “I would get up in the middle of the night when he cried, lie him back down and he would start to cry again,” he recalled. “I’d give him to my wife, who has a lot more patience, and ask her to ‘make him stop.’
“Even with the resources we had-and two parents-it was still frustrating, and I began to understand how parents could get more and more frustrated.”
About the same time Dr. Dias was dealing with his own crying son he treated three babies suffering from shaken baby syndrome, cementing his desire to find a way to help stressed-out parents cope.
Dr. Dias funded the program for the first two years with $20,000 in grant money from the William B. Hoyt Memorial Children’s and Family Trust. After viewing several videos, he decided that the Midwest Children’s Center Resource Center had the best one and secured their permission to use it. He also purchased for a small price a leaflet from the American Academy of Pediatrics. “Everything we use in the program is put out by other people,” he said.
Nurses are asked to present the materials at a separate time from information about care of the umbilical cord, the use of care seats and other safety information. This way, the warning about shaking is not lost in the shuffle.
All the materials are available in English and Spanish.
In the program’s first two years, 15 of 16 hospitals in an eight-county region around Buffalo agreed to participate in the program by asking new parents to view the materials. Most also had parents sign an affidavit attesting to their having received the material and understanding the risks of shaking a baby. Forty-seven percent of the live births in the hospitals were followed by a signed affidavit from one or both parents. Since December 2000, a total of 35 hospitals in 17 counties have been participating, and nearly 80 percent of live births have been accompanied by a signed affidavit.
The average annual number of shaken babies in the counties around Buffalo before the program began was 6.5 cases. There were five cases overall the first two years after the program was introduced, and three of these children were born before the program had begun. (Of the other two, one involved a father who had signed the affidavit and in the second neither parent had signed the affidavit.)
Exact numbers on how many U.S. babies are killed each year from forceful shaking are hard to come by because state health and criminal justice agencies often lump them with other traumatic brain injuries. Estimates range from 1,000 to 1,400. The mortality rate is believed to be about 25 percent, meaning as many as 5,600 babies are severely injured each year from shaking.
Widespread Interest
Dr. Dias has received calls from hospitals and child abuse agencies across the country interested in imitating his program. Inspired by Dr. Dias’ program, hospitals in the Salt Lake City area already are showing a video on shaken baby syndrome.
Unfortunately, Dr. Dias has yet to receive much interest from neurosurgeons. “Hopefully, this [story] will energize some neurosurgeons to take a more active role in this most neglected area of our specialty,” he said.
The program was a relatively easy sell to hospitals and the nurses themselves, even though nurses are stretched thin today with increased duties, said Dr. Dias. “People realize it’s worth the effort. It saves lives,” he said.
The extra work it imposed on him also was manageable, he said. Once he decided to plunge ahead with the project, he changed his research interest from the development of the spinal cord and brain to abusive head injury.
Plus, like other necessary tasks, the administrative duties of the program melded into the rest of his workday. “You find the time,” explained Dr. Dias, who took a new position with Penn State Hershey Medical Center in July but continues to coordinate the program.
The program’s day-to-day administration is run by two nurses, hired this year thanks to $130,000 in funding by the Hoyt Foundation. One of the nurses, Kim M. Smith, left her job as manager of the mother/baby unit at Children’s Hospital to help oversee the program.
“I just love it. It’s unbelievably valuable,” she said.
Dr. Dias’ goal is to see the program used throughout New York. A key ally is Sam Hoyt, a state representative whose father’s trust funded the program’s first phase. Assemblyman Hoyt has recently petitioned Governor Pataki and the state legislature to provide enough funding to take this program statewide.