From Boston MA to Enid OK, Missing the Real Point on Keeping Babies Safe

From the Enid News & Eagle, a reminder that there is often an interesting contrast between the words said, and the headline that results..

Shaken baby syndrome often happens with first-time parentsBy Phyllis Zorn, Staff WriterEnid News & EagleENID, Okla. — Marie Holsten, district director for Oklahoma Department of Human Services, said incidents of shaken baby syndrome often happen with first-time parents, but that’s not always the scenario.
Shaking of the baby can happen when the child is in the care of anyone not prepared to deal with the crying, or when the person caring for the child already is overwhelmed and frustrated by other things, and the crying of the baby becomes the trigger that prompts their frustration to boil over, she said. 

It's actually a fairly good article, as far as it goes.  However, this is how it ends:

Holsten emphasizes parents should be mindful of who they leave in charge of their children.
“A lot of people are going back to work,” Holsten said. “Make sure you get a licensed day care provider. You need to be careful who you are leaving your child with.”

While there's nothing wrong with recommending that parents hire a licensed day care provider, there's much more than needs to be done besides checking for a license (it should be no surprise that not everyone who claims to be licensed actually is...).  My thoughts:

Good article, but hiring a licensed day care provider is not sufficient by itself:  a parent needs to take three more steps. 
 First, ask every caregiver if they know that children as old as 5 years of age are vulnerable to an inflicted head injury, and if they have participated in a safety education program that included info about shaken baby prevention.  Second, ask if they have a coping plan for the inevitable moments of frustration.  Third, give them permission to call you if there are times when they need to talk.  
If it feels awkward, ask yourself if you'd rather leave your baby with someone who doesn't know how vulnerable babies and infants are, who doesn't have a plan to cope, and who is going to be afraid to call you if they need to.
If it still feels awkward, just let the caregiver know that you only want to help her (or him) know what they need to know to help you keep the child safe.

The advice from Enid is not much different than this MD blogger who writes on the Boston.com site

Three things parents can do to keep their child safe from child abuse Comments (12) 

Posted by Dr. Claire McCarthy  January 23, 2013 11:25 AM

• 

  92
•  2

The news of the Cambridge toddler that recently died from injuries has parents terrified.

While this is really understandable, I think that instead of just being terrified we should use this as a moment to really think about what we can do to keep children safe from child abuse. While nothing can prevent all abuse, there are things that parents can do. Here are three:  

Never shake a baby. Shaken Baby Syndrome (SBS), which is when children are shaken hard enough to cause brain damage, is the leading cause of child abuse death in the United States. The most common reason SBS happens? Inconsolable crying. When you mix a baby that won't stop screaming with a stressed-out, overwhelmed caregiver, bad things can and do happen.
If you've got a baby that screams a lot, check in with your doctor--but often it's just normal crying. And in those cases, you need to take care of not just your baby but yourself. Sometimes the best way to care for both of you is to put the baby in a safe place, like his crib, and take a moment to calm down. Here in Massachusetts, you can call the Parental Stress Hotline at 800-632-8188.
Make sure that everyone who cares for your child knows the dangers of shaking. To learn more about SBS and how to prevent it, visit the CDC's Heads Up: Prevent Shaken Baby Syndrome website.

Know the signs of child abuse. It's not always obvious. The Department of Health and Human Services has a fact sheet that has all sorts of information about recognizing abuse and neglect, but here are some of the signs that parents and caregivers should watch for:

• Any unexplained bruise or other injury (or an explanation for one that doesn't make sense)

• Frequent bruises or injuries, even if an explanation is given

• Changes in behavior, such as acting withdrawn, sad, angry or afraid. An occasional off day is usually normal, but if the changes are persistent or recurrent it could be a sign of a problem.

• Changes in appetite or sleep (including trouble falling asleep, nightmares, or bedwetting). Again, only worrisome if persistent--and there can be lots of other explanations.

• Behaviors or statements from children that are odd or not normal for their age (like talking about sex)

• Negative comments about the child from the parent or caregiver--and/or lack of nurturing/happy interactions with child

• The child expresses fear or dislike of the parent/caregiver

Remember--these are just a few of the signs, and could have other explanations. But if you see them, let someone know--like your doctor, or the Department of Children and Families.

Check out all your child's caregivers thoroughly. If you use a daycare center or family daycare, be sure that they are licensed--and check with your local licensing board to find out if there have ever been any concerns or complaints. If you use a nanny or babysitter, do background checks--including in other states the person has lived. Since most child abuse happens when a child is left alone with a caregiver, doing your homework is really important. Get plenty of references. Ask lots of questions--and be sure you communicate with them regularly about your child's behavior and needs. Ask friends and neighbors who might interact with the nanny or babysitter to keep an eye out and let you know if anything concerns them--and make surprise visits regularly.
It's impossible to know everything about anybody, no matter how well you do your homework--that's what so scary about this. Keeping your antennae up can help; if for any reason something about a caregiver doesn't feel quite right to you, listen to that feeling. Don't ignore it. It's always better to be safe--after all, nothing will ever be more important than your child.
For more about how all of us can help to prevent child abuse, visit the website of Prevent Child Abuse America.

This is what I said then (and I'll say it again):

geolith01/24/2013 12:03 AMWell, as advice goes, this is better than nothing, but it falls short of good.

First, given that the impetus for the advice is a child shaken by a nanny, it would be far more effective to discuss how important it is that parents educate caregivers about the vulnerability of young children to inflicted head injury, and how to do that in a constructive, non-accusatory way.   Telling someone that "you shouldn't shake a baby" is hard to do, and hard to listen to.  Telling someone that I want you to help protect our child from head injury is a lot easier for both.

Second, background checks on a child care provider are poor advice for a number of reasons.   Most people who have options trust their own judgment about who to leave their child with, so see little reason to take the time and bear the cost of having a background check done.  Plus, once you've decided, the reality is that it's more than a little awkard to bring up the background check.  And more often than not, caregivers who inflict injury have no record.

Third, all those recommendations, and not ONE mention of the most important step?  Parents need to talk TO the caregiver and find out what he or she knows about the danger of inflicted injury and how they plan to cope with the inevitable moments of frustration.  And please, give them permission to call you if they even begin to feel the frustration is taking over.
I admire and respect doctors.  

But medical school teaches them how to treat illness, not how to educate people about prevention.  If you're learning how to drive, you don't need a mechanic or a body shop operator to tell you about the consequences of motor vehicle accidents; you need an educator to help you learn how to stay out of one.

By the way, Mass Campaign for Children has been doing some excellent work educating new parents and caregivers.  Ask Jetta Brinnier to do a follow up article about the experience of learning how to give good advice to new parents...