Sunday, July 27, 2008

A good overview article from USA Today

'The right time' for action

"Parents already knew that violent shaking was a bad thing," says Mark Dias, a neurosurgeon who developed prevention programs in New York and Pennsylvania. The program has parents review information about the syndrome, and they have one-on-one counseling with a nurse after the baby's birth. "They needed to be reminded in the right time and in the right setting." [the "teachable moment"]

Researchers are hoping to replicate results of a pilot program created by Dias in upstate New York that reduced such cases by 47% from 1998 to 2003.

In North Carolina, every family with a new baby now receives a DVD and a booklet describing the "period of PURPLE crying," an acronym that helps parents understand all children increasingly will cry uncontrollably from about 2 weeks old until about 5 or 6 months. P stands for peak of crying; U for unexpected; R for resists soothing; P for pain-like face; L for long-lasting; E for evening.

The message is repeated by a nurse after the birth and again by a pediatrician at the child's checkups at 2 months and 4 months.

Message received

"We're trying to get people — the whole society, not just mothers and fathers … to understand early infant crying is not because the baby is bad or because the parents are bad," says Ron Barr, who created the PURPLE program and studied the link between shaken babies and crying.

The programs encourage parents to put a crying child in a safe place and walk away before they get too frustrated.

"What I see here is the relief when a parent hears (uncontrollable crying) is normal," says Cindy Brown, a pediatrician at Mission Hospital in Asheville, N.C., one of the first medical centers in the state to distribute the prevention materials.

Both programs, which are financed for five years in part by the Centers for Disease Control and Prevention, will track infant head traumas until 2012.

Says Runyan, "It's our view that the majority of shaken babies are not premeditated but a desperate parent who has run out of gas who needs the kid to be quiet."

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