An article from Montana that once again points out the difficulty in prosecuting many SBS cases. One interesting aspect is that the case was tried in federal court, presumably because it took place on a reservation...

Jury acquits dad in shaken-baby case
By CLAIR JOHNSON
Of The Gazette Staff

A federal jury Tuesday afternoon acquitted a Busby man accused of seriously injuring his infant son by shaking him.

The panel found Merlin Wade Littlesun Sr., 22, not guilty of assault resulting in serious bodily injury after deliberating about 2½ hours in the two-day trial.

As the clerk announced the verdict, about a dozen of Littlesun's family members and supporters jumped to their feet and applauded and cheered the verdict, prompting an angry rebuke from Chief U.S. District Judge Richard Cebull.

"Get them out of here," yelled Cebull, who stood up and pointed at the group. Courtroom security guards directed Littlesun's supporters out of the courtroom and the building. After the courtroom had been cleared, the judge dismissed the indictment against Littlesun and ordered him released from custody.

Littlesun testified Tuesday morning that he did not shake his son as alleged on May 10, 2006. Littlesun's testimony lasted barely five minutes, and he gave mostly yes-or-no answers. Littlesun said he was sleeping when he is alleged to have shaken his 4-month-old son, Merlin Wade Littlesun Jr., hard enough to cause head trauma. He drove the baby's mother, Nicole Fisher, and his son to meet the ambulance as it was coming from Lame Deer, he said. Then he returned home to get a diaper bag and baby supplies.

Under questioning by Assistant U.S. Attorney Lori Suek, Littlesun said he was aware of bruises on the baby and asked Fisher about it but did not call the police or get the bruises checked. He suspected Fisher caused the injuries because "she just looked down," he said.

Littlesun also said he told the FBI agent he took responsibility for what happened even though he didn't do it. He acknowledged that he didn't tell investigators he suspected Fisher of causing the injuries.

The prosecution's witnesses included Fisher, others who were present in Littlesun's residence at the time and doctors who treated the baby.

Dr. Richard Stevens, a pediatrician who treated the infant, said the boy is now doing "quite well" even though his injuries were life-threatening. He was flown to a Denver hospital, where pressure on his brain was relieved.

In closing arguments, Suek recalled Fisher's testimony that she saw Littlesun in their bedroom holding the baby in his arms and that his head was shaking violently. She told him to stop and left the room. She could hear her baby crying but was afraid of Littlesun, she said.

Fisher went back in a few minutes later, picked up her baby and was holding him when he began having a seizure.

Fisher initially lied to investigators and medical personnel about what happened because she was scared of Littlesun's family, Suek said. She told the truth after she moved out of the house about a year later, she said.

Defense attorney Robert Kelleher Jr. argued in closing that Fisher caused the injuries and that there were serious problems with her testimony. According to Fisher's account, it was about 20 minutes after she allegedly saw Littlesun shaking their son until they called an ambulance.

But defense witness Dr. Thomas Bennett, a forensic pathologist who has studied shaken-baby syndrome, said a baby would experience seizures almost immediately after being shaken, Kelleher said. Bennett also said it can take only a few seconds to shake a baby hard enough to injure its brain.

Fisher was a 17-year-old mother of an infant and also had a toddler at the time, Kelleher said. She was "multitasking," trying to get breakfast ready and walking around the house with the baby, he continued, and "it only takes a second for her to snap and do this to the baby."

He also discounted Fisher's fear of Littlesun and his family. Fisher was alone with the doctors at St. Vincent Healthcare, where her son had been transferred from Lame Deer, and had the opportunity to say Littlesun caused the injuries.

"She did not tell anybody. Why? Because she's the one who did it," he said.

And welcome to the Hallmark Health Systems hospitals in Melrose and Medford, Masssachusetts, who have joined an effort spurred by Middlesex County's District Attorney, Gerry Leone, to educate new parents about Shaken Baby Syndrome before they leave the hospital.

Three news stories about Shaken Baby Syndrome caught my eye today:

Today's Hartford Courant has a compelling article by Kathy Megan about SBS. It shows the consequences of shaking a child, and discusses prevention activities in Connecticut...

The Cambridge Chronicle reports that the Cambridge Health Alliance and eight other Massachusetts hospitals will be joining an initiative undertaken by District Attorney Gerry Leone to educate new parents about the vulnerability of young children to shaking injuries.

Aiden Stein turned five this week. This article demonstrates that SBS truly begets tragedies upon tragedy. He survived being shaken by his father, but was left dumb and blind. His maternal grandmother believes his time has come. His paternal grandmother believes Aiden suffers from a birth defect.

And finally, sad news from the UK about a paramedic arrested for shaking his three month old son.

Mothergoosemouse posted about the changes that come with motherhood, anticipated or not.

She describes watching a shaken baby prevention video in hospital....

Before I had children of my own, I reacted to news of tragedies concerning children much differently. I was saddened, disturbed, sorry for the family - but it didn’t prey on my subconscious like it does now.

I can’t read the articles or listen to the news reports. I struggle with the blog posts,which are mercifully few and far between. Before being discharged from the
hospital with CJ, I was required to watch a video about shaken baby syndrome. I burst into tears afterward, and the visuals from the video stay with me even now. The “Never Shake a Baby” radio and TV ads cause me to change the channel. Even typing these words makes me well up.

This was my response....

I’m curious to know whether you think the hospital could have “framed” the
info in a way that would have changed your response.
We advocate for hospital based prevention education and encourage the nurses to present the information not as an obligation (”you should never shake your baby”) but as an opportunity (”this will help you learn about the causes of shaking injuries
so you can help protect your baby against injuries”).
It’s easier for the parents and for the educators. It’s easier for hospitals too: everyone benefits.
And it’s very important for parents to be able to educate - not just tell - all the other caregivers around their child (not just child care, but baby sitters, sibling, the neighbor who’s an emergency backup): shaking is dangerous to young children (up to 5 years old) and frustration is normal, so even good caregivers need to recognize when that response is getting out of hand and have a simple coping plan ready.
It can be as simple as putting the child in a safe place, catching your breathe and calling someone to vent for a few minutes. The first step can be hardest, especially for a parent: you have to acknowledge the stress…
And the best thing is that once a parent understands the importance of positively educating other caregivers, and accepts the role of educator, they reinforce their own knowledge and behavior.
It’s certainly scary to learn about something that could hurt your child which you
have no control over: it’s much better to learn about the danger and what
you can do to protect your child.
Eduation is effective. Hospitals in the Buffalo area of New York have been doing education since 1998: since they started, the rate of inflicted infant head injury has dropped by 50%.
So you may not be able to avoid thinking about the tragedies - there are more than most people realize - but I hope you will also take advantage of your opportunity to
share knowledge about preventing those injuries.

This summary of Australian research on parenting education prompts three thoughts:

- why did they create a parenting program (the "first"), rather than adapt and evaluate one that has been shown effective, such as the home-visiting program developed by David Olds?;
- as research seems to show that birth is the "teachable moment", why did they wait until 8 months to implement it?; and
- doesn't it seem that a reduction in harsh or abusive parenting behavior is a worthwhile result?

Parenting Program Does Not Prevent Toddler Behavior Problems, Study Shows
ScienceDaily (Feb. 3, 2008) — A study of the first universal parenting programme, designed to prevent early child behaviour problems, shows that it has little impact on toddler behaviour.
Behaviour problems affect up to 20 per cent of children and have major personal, societal and economic ramifications. Left untreated, up to half of behaviour problems in preschool children develop into later mental health problems.
Prevention targeted to high-risk families can be effective, but has limited reach and may stigmatise. Universal programmes offered to all families could address these concerns, but their effectiveness is uncertain.
The study, conducted at the Centre for Community Child Health (CCCH) in Melbourne, Australia, is published by the British Medical Journal.
Researchers from the CCCH and the Parenting Research Centre, with input from maternal and child health nurses, designed a programme suitable for all parents to be delivered by trained health professionals in primary care. The programme aimed to prevent child behaviour problems, such as defiance and aggression, and improve parenting and maternal mental health.
Over 700 mothers of 8 month-old infants participated in the study and were randomised to either the programme (three sessions at age 8-15 months) or usual care from their local Maternal and Child Health centre. Mothers were surveyed throughout the study and their mental health was assessed when their children reached 18 and 24 months.
At 18 months, child behaviour and parenting scores were similar between the two groups. By age 24 months, parents on the programme were less likely to report harsh or abusive parenting and unreasonable expectations of child development, but there was no improvement in maternal distress or toddler behaviour.
This was the first trial to evaluate a universal parenting programme involving families from all social backgrounds, say the authors.
They conclude that the outcomes are insufficient to support widespread introduction of this programme to prevent toddler behaviour problems.

BMJ-British Medical Journal (2008, February 3). Parenting Program Does Not Prevent Toddler Behavior Problems, Study Shows. ScienceDaily. Retrieved September 1, 2008, from http://www.sciencedaily.com/ /releases/2008/01/080131214534.htm

The New York State Fatherhood Initiative is hosting a statewide conference in Albany

On October 6th-9th the Office of Temporary and Disability Assistance, along with the Office of Children and Family Services, will host the first New York Statewide Fatherhood Conference. The conference will take place at the Desmond Hotel in Albany. Participants from around the country will convene to explore the issues, concerns, and impact of fatherlessness in
the lives of our children and families.

They've doing some good work: for instance, while it used to be said that babies
don't come with an owner's manual, they've published one. It's an interesting
tool for new dads and it does include information about Shaken Baby Syndrome...

OTDA has released A Driver's Manual for New Dads (1mb, PDF) that offers new dads information
that will help them be a good dad to their child, including supporting a partner emotionally during and after pregnancy and tips on interacting with a new baby.

An interesting story from MSNBC's archives on how parents can help kids cope with the pain of vaccination.

Of course, in some cases, vaccinations can cause soreness and irritability that persists for a few days. That's important information to share with child care providers and other caregivers, so they're prepared to cope.

Soothing the screams from childhood vaccines
Study suggests sweetened pacifiers, blowing bubbles and other distractions

CHICAGO - Some children sob, others scream, and some get so upset they have to be restrained by medical staff. But a new study suggests parents can ease the anxiety about immunizations by telling a joke, reading a book or bringing a favorite toy from home.

Other proven distraction techniques include blowing soap bubbles and, for under six months, using a pacifier dipped in sugar water.

“All of those kinds of things can take children’s minds away from the needle poised to go into their arm,” said lead author Dr. Neil L. Schechter, the director of the Pain Relief Program at Connecticut Children’s Medical Center.

The study appears in the May 2007 edition of Pediatrics.

Parents who are overly apologetic or excessively reassuring during the procedure can actually cause more distress, the research found. Instead, parents should adopt a “matter-of-fact, supportive, nonapologetic approach,” researchers said.

Schechter’s team reviewed hundreds of previous studies regarding pediatric immunizations and referenced about 120 in their article, in which they also make recommendations for doctors.

While some may dismiss the shots as a rite of passage, children’s fear can interfere with important discussions pediatricians need to have with parents, said Schechter, who is also a professor of pediatrics at the University of Connecticut School of Medicine and a pediatrician at Hartford’s St. Francis Hospital.

At Children’s Memorial Hospital in Chicago, child life specialist Emily Rogers helps young patients deal with procedures including injections and getting their blood drawn.

Rogers said she believed the study was a valuable one. While somewhat surprised with findings that overly empathetic parents can cause more distress, she theorized it’s because children became scared and confused when they feel their parents lack control over a situation.

She carries a “distraction bag” packed with pinwheels, bubbles, whistles and books, and she also helps young patients practice relaxation and breathing techniques.

Rogers said it’s important parents not bargain with their child, instead emphasizing while it’s OK to feel scared, the medical procedure is designed to help them and the child isn’t being punished.
And a reminder of why vaccination is still a necessary thing...

Vaccine refusals mean more measles
Aug. 21: The CDC reported Thursday that the number of measles cases in the U.S. is at its highest level since 1997, almost half of which involve children whose parents refused to have them vaccinated. (NBC's Robert Bazell reported this story in August, 2007)

Diane at Foster Family Talk has a post about a shaken baby case in Florida. She reminds parents of the importance of checking references of child care providers.

This was my response:

A parent should certainly research all available references and history.

However, while that's necessary, it's not sufficient to ensure that you've done everything you can to protect your child.

You must talk with your child care provider about the danger of shaking young children, that frustration and anger is a normal response to caring for young children, and they need to agree to follow a simple coping plan: recognize that frustration, leave the baby in a safe place and call someone, either as a safety vent or to acknowledge the frustration. They need to know that it's OK with you to have feelings of frustration.

It can be done in a manner that doesn't accuse, but instead talks about sharing knowledge and opportunity to protect your child from injury. If your child is an infant, it can be especially effective coupled with SIDS information.

In New York and several other states, licensed providers must have training on the causes, consequences and prevention of shaken baby. That obligation doesn't extend to "exempt" providers, and it's not complete assurance - providers have attended training and still shaken children.

But this education model is based on a program for new parents in Buffalo that reduced the incidence of shaken babies and inflicted injuries by 50%.

Not perfect, but for a simple 15 minute intervention, pretty effective insurance!...

So, if a parent just checks references, they will have a false sense of security.

Sharing information with all other caregivers of your child about the causes and consequences of SBS and the need for a simple coping plan - and ensuring they share your commitment to using it - is the key.

And not only will that help protect your child, it will help protect others.

For more info, visit the resources page on www.skippervigil.com

Unfortunately, the new Revolution Health website provides some good examples of lost opportunities to prevent shaking and other inflicted injuries....

Searching the website finds numerous pages on colic, which make no mention of the frustation and anger that a caregiver can experience when dealing with a colicky child, or how parents can help prepare a coping plan.

The overview page on colic suggests indirectly that colic could be upsetting, but offers only this advice on managing that upset:

Do what you can to comfort your baby, but accept that sometimes nothing works. If you feel stressed or worn out, ask a friend or family member to give you a
break. Take good care of yourself, and remember that colic will go away soon.

What to expect from colic is another page that fails to mention that frustration and anger can be a normal response, or that it is even more necessary to talk with the other caregivers of your child and discuss coping behaviors, so these less experienced caregivers have an opportunity to prepare for colic.

On the other hand, a page on crying under age 3 does discuss SBS. It could be improved by redirecting the focus from "you shouldn't shake your baby" and not claiming that throwing a child in the air will cause SBS

Never shake or harm your child. Shaking a child in anger or playing rough, such as throwing him or her into the air, can injure the brain.

While the Revolution site does have several pages on SBS, it's only the last page that talks about prevention.

On a health oriented website, that seems to be putting a cart before the horse.

If you wonder why journalists write about child abuse, but not prevention efforts, this teaser for the Dart Fellowship suggests one explanation:

JOURNALISM FELLOWSHIP Applications will be accepted through July 30 for the 2008 Dart Center Ochberg Fellowships in Journalism and Trauma.

The Dart Center Ochberg Fellows Program is designed for mid-career journalists who want to deepen their knowledge of emotional trauma and improve coverage of violence, conflict and tragedy.

Details and applications available at www.dartcenter.org/fellowships.

A book review in the New York Times points out some reasons why thinking we're safe can be unsafe....

Some of those "thinks" to keep in mind, whether designing community prevention initiatives or an individual, personalized prevention program for your child:

- we think we're more skilled than experience suggests;
- when routines allow us to think less about safety, we are distracted from anticipating stress events and less prepared to cope; and
- we think we - and other caregivers, like babysitters and child care providers - know what we need to know about the skills required to raise a child.

Assuming you're safe can be fatal. Assuming you "know" what any individual taking care of your child will or won't do can also have tragic consequences.

Nowadays, the cause of collisions, or one of them, is people believing they’re better drivers than they are. We base our judgment on the number of crashes we’ve been in, rather than on the number of accidents we narrowly avoid, which, if we’re being honest (or we’re being me), happen just about every time we drive.

Compounding this vehicular hubris is the fact that most of the driving we do appears to be safer than it is. Driving rarely commands 100 percent of our attention, and so we feel comfortable multitasking: talking on the phone, unfolding a map, taking in the Barca-Lounger on the road’s shoulder. Vanderbilt cites a statistic that nearly 80 percent of crashes involve drivers not paying attention for up to three seconds. Thus the places that seem the most dangerous — narrow roads, hairpin turns — are rarely where people mess up. “Most crashes,” Vanderbilt writes, “happen on dry roads, on clear, sunny days, to sober drivers.” For this reason, roads that could be straight are often constructed with curves — simply to keep drivers on the ball.

This basic truth — feeling safe kills — lies beneath many of the book’s insights. Americans think roundabouts are more dangerous than intersections with traffic lights. Roundabouts require you to adjust your speed, to merge, in short, to pay attention. At an intersection, we simply watch the light. And so we may not notice the red-light runner coming at us or the pedestrian stepping off the curb. A study that followed 24 intersections that had been converted from signals or stop signs to roundabouts showed an almost 90 percent drop in fatal crashes after the change.

For similar reasons, S.U.V.’s are more dangerous than cars. Not just because they’re slower to stop and harder to maneuver, but because — by conferring a sense of safety — they invite careless behavior. “The safer cars get,” Vanderbilt says, “the more risks drivers choose to take.” (S.U.V. drivers are more likely to not bother with their seat belts, to talk on cellphones, and to not wear seat belts while talking on cellphones.) So it goes for much of the driving universe. More people are killed while crossing in crosswalks than while jaywalking. Drivers pass bicyclists more closely on a road with bike lanes than on one without.

An interesting article by Sharon Begley in Newsweek discusses the diverse impact of genes on child behavior (and in the process, removes any doubt that every child is different).

There's an interesting point about fussy babies: their behavior is much more susceptible to being shaped by their parents.

Hopefully, as word spreads, it will help those parents with colicky babies, or with high need for control, to know that some things are indeed beyond their control.

PS. The asides about professionals in the child advice business are also of interest - when advice works, it may well be because the baby has characteristics that fit the advice, and many professionals resist, or are at least reluctant to acknowledge, the importance of genetic factors.

But I Did Everything Right!
DNA discoveries are revealing why even the best parenting doesn't have the effects experts promise, from breast-feeding to letting kids learn from mistakes.
By Sharon Begley NEWSWEEK
Published Aug 9, 2008 - Aug. 18-25, 2008 issue

If there is one thing experts on child development agree on, it is that kids learn best when they are allowed to make mistakes and feel the consequences. So Mom and Dad hold back as their toddler tries again and again to cram a round peg into a square hole. They feel her pain as playmates shun her for being pushy, hoping s he'll learn to back off. They let their teen stay up too late before a test, hoping a dismal grade will teach her to get a good night's sleep but believing that ordering her to get to bed right now will not: kids who experience setbacks rather than having them short-circuited by a controlling parent learn not to repeat the dumb behavior.

But not, it seems, all kids. In about 30 percent, the coils of their DNA carry a glitch, one that leaves their brains with few dopamine receptors, molecules that act as docking ports for one of the neurochemicals that carry our thoughts and emotions. A paucity of dopamine receptors is linked to an inability to avoid self-destructive behavior such as illicit drug use. But the effects spill beyond such extremes.

Children with the genetic variant are unable to learn from mistakes. No matter how many tests they blow by partying the night before, the lesson just doesn't sink in.

The discovery, reported last December, is part of what is fast becoming the newest frontier in studies of why children turn out as they do. Since the first advice book for American parents appeared in 1811, the child-rearing industry, as well as researchers who have made child development a science, have assumed that, although every child is an individual, there are certain universals. If parents are too take-charge about homework, the child becomes disengaged and eventually gives up; if they are warm and affectionate, kids don't act out. But while most children do respond the way research shows, there have always been "outliers," kids who don't turn out the way experts promise.

After years of ignoring those children, a few scientists now realize that they are telling us something that promises to revolutionize our understanding of child development. In an echo of "personalized medicine" (matching drugs to people's DNA), scientists are finding that how parents treat their children is filtered through the prism of DNA. Parents may intuit that, as they notice that what worked with one child is failing abysmally with another, but now science is pinpointing exactly what combinations of nature and nurture spell gridlock.

It is finally dawning on experts that "individual genetic differences are the 800-pound gorilla of child development," says Jack Shonkoff, director of the Center on the Developing Child at Harvard University. "The promise of genomics is that you will be able to tailor experiences as we tailor drugs."

Research showing that the most scientifically rigorous child-rearing advice can blow up on you couldn't come at a worse time for the millions of American parents who are desperate for direction. They are gobbling up how-to books and DVDs, even hiring coaches and consultants. They are tearing their hair out over conflicting advice on even such basics as sleep—let baby cry herself to sleep? Co-sleep? (As it turns out, the conflicting advice may reflect the fact that the "experts' " experience happens to have beenwith children whose genetic disposition is amenable to their way of doing things.)

More than earlier generations, new parents are panicked that they're going to screw up. That feeling is fed by posts on Web sites such as UrbanBaby, in which someone, somewhere, can be counted on to flame your every parenting decision.

But for parents who look back in sadness—perplexed that although they did everything "right," their child is not as kind, or intelligent, or self-confident, or well adjusted as the recipes promised—the emerging science offers an explanation, and perhaps an out: with the DNA stacked against you, it wasn't your fault.

One of the strongest and most counterintuitive findings in this nascent field is that children with a sweet temperament, which is under strong genetic control, are the least likely to emulate their parents and absorb the lessons they teach, while fussy kids are the most likely to do so.

Fussy children have a hypersensitive nervous system that is keenly attuned to its surroundings—including what Mom and Dad do and say. In studies that are shaking up textbook dogmas, Jay Belsky of Birkbeck University of London has shown that fussy babies are therefore wired to be more strongly shaped by their parents than mellower children are.

It is the fussy baby who, read to night after dutiful night, is likely to develop a love of books; the mellow baby, given the same literary diet, might just as easily grow into a teen who has no interest in reading anything longer than a text message. The mellow baby, immune to your charms, is more likely to show signs of road rage from the day she first takes her tricycle out for a spin, even though she grew up watching your saintly temper control.

Children who go with the flow of new people and new situations are like Teflon: good parenting doesn't stick to them—but neither, necessarily, does bad parenting. They're the young adults who can't form close, meaningful relationships despite the unconditional love you showed them. "Kids with difficult temperaments are more sensitive to the effects of parenting," says Belsky. "You can get by with sloppier parenting if you have a 'good temperament' kid." Even children who fall between the extremes are generally closer to one than the other.

Although whether you have an easy or a fussy child is obvious, other innate differences that shape whether and how a child will respond to how parents raise them are less apparent. But since they reflect the presence of a DNA variant, they are all candidates for being pinpointed with a genetic test that will help parents know what to expect:

• The gene variant that influences whether children learn from their mistakes. With the misspelled gene, brains have about 30 percent fewer dopamine receptors and less activity in the brain's frontal cortex (the site of higher-order thinking, including monitoring negative feedback) and hippocampus (memory) than do people with the more common form of the gene. In an experiment at the Max Planck Institute for Neurological Research in Germany, people with the misspelling weren't able to avoid choices that they were told over and over were incorrect. Numerous other studies have linked this gene variant to addiction, obesity and compulsive gambling, suggesting that the underlying problem is trouble learning the negative consequences of your actions.

• The DNA variant that affects whether a baby's brain development will be spurred by breast-feeding, which has been reported to confer an extra half-dozen or so IQ points by kindergarten. But not all breast-fed babies are little Einsteins, making their mothers wonder why all the milk-stained blouses didn't seem to boost cognitive development. The reason seems to be that there are two forms of a gene called FADS2. In the 90 percent of babies who carry the "C" form, breast-feeding raises intelligence by an average of nearly seven IQ points, scientists led by Terrie Moffitt and Avshalom Caspi of Duke University reported last year. This version of FADS2 produces an enzyme that helps convert the fatty acids in breast milk into compounds that help signals zip along brain neurons and spur neurons to sprout connections, which underlie intelli gence, memory and creativity. The 10 percent of babies who carry the other form of the gene lack the enzyme and therefore derive no cognitive benefit from breast-feeding (though they still get an immune-system boost from it).

• DNA variants can protect children from bad parenting. For instance, most girls who are sexually abused are at higher risk for becoming alcoholics, as well as for developing other mental-health problems. But girls who have a "sluggish" version of the gene called MAOA seem to be vaccinated against this effect, reported scientists led by neurogeneticist David Goldman of the National Institute on Alcohol Abuse and Alcoholism last year. With the active version of MAOA, the brain's hippocampus—which processes emotional experiences and memories—becomes hyperactivated when it remembers something upsetting, such as abuse, and the woman turns to alcohol for solace. With the sluggish version, those memories lose their awful power.

Another protective gene insulates children from the effects of an emotionally distant mother, one who is cold and uncaring, who turns away when her child feels the pain of a skinned knee no less than from a crushed dream. That is supposed to make a child more likely to develop "externalizing behavior," acting out in a bid for attention. But children with a certain form of a gene called DRD4, which stands for dopamine-receptor D4, are Teflon-coated, at little to no risk of becoming emotionally insecure as a result of mothers who are emotionally distant, found a 2007 study.

The discoveries questioning the connection between what parents do and how children turn out has not exactly taken the science of child development by storm. That seems to reflect a culture clash within the field. Most researchers who study child development were trained as psychologists, and—to overgeneralize, but only a little—are uncomfortable with or even suspicious of genetics. Geneticists tend to see behavioral research as squishy, not hard science.

That produces a body of scientific literature that is remarkably ignorant of genetics. As we reported in this story, we were struck by how clueless so many "experts" in child development were about the new genetics—and how resistant they were to it. Almost all were unaware of the studies showing that genetics acts as a filter between environment and child, letting some influences in and keeping others out. "Even the stuff published in the best journals ignores the underlying genetics," says one leader in the field.

Since companies already offer storefront DNA tests, the day is not far off when parents can determine their child's MAOA or DRD4 status, or the presence of any other variant that influences the effect of parenting. But perhaps it is time to acknowledge that there is only so much influence parents can h ave. In her best-selling book "I Feel Bad About My Neck," Nora Ephron laments how American society "came to believe in the perfectibility of the child just as it also came to believe in the conflicting theory that virtually everything in human nature was genetic." Both views—that everything is genetic and that parents can transform a child like a lump of clay—are as wrong as wrong can be.

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."

Some good words from a new father that show the value of hospital based education for new parents. Following that, a mother talks about colic and the feelings that follow ...

In the hospital they made us watch this really sad movie on shaken baby syndrome (Serene probably doesn't even remember it) and I thought how in the world could someone do that to their baby? I was shocked! Then, after about a week of 1.5 hour catnaps it all started to make sense how someone could lose control. I had to turn on the light sometimes just to make sure that the writhing object in my arms was in fact my baby and not a screaming banshee. I write with some hyperbole to emphasize the point but rest be assured that I never considered hurting my baby even during her most demonic frenzies.

Now, from The Mommy 'n Baby Page, an excellent perspective on what colic means to a mother...

Colic31st July 2008, 06:42 pm Some of us are lucky enough not to have to have a colicky baby, but others aren’t so blessed. My son was never diagnosed with colic, but often he would cry for hours each day, sometimes as many as four or five.

I can’t imagine having a baby who cries more then that, but there are some. My husband’s uncle would tell us stories of the two colicky babies that he and his wife raised. He would talk about two am drives to put the baby asleep and get some peace and quite.

Unfortunatly colic isn’t something we understand. We aren’t sure why some babies re colicky and others aren’t.

Without knowing the cause we aren’t sure how to make it stop either. If you have spent hours singing, pacing, dancing (I used to dance with my son who would sometimes quiet down with this method, at least until I stopped!), driving, crying, feeding, changing, and in all other ways trying to get through it, then you know what it is like to wish there was a way out.

Sometimes thoughts creep up, especailly after hours of hard work trying to make the crying stop to no avail. However, you have to work to combat these thoughts. One of the most common is that you are a bad mom. This thought can creep in as you aren’t making your baby happy.

It is hard to handle, but if you are trying and you care then you are a good mom. You have to remind yourself of the times when your baby isn’t crying and the love you feel then. You’re a good mom who is facing a difficult challenge! You are doing your best and that is better then many. Sure it isn’t easy, but you love your baby (especially when they aren’t crying) and you face it each day.Often times it is easy to feel alone when you are dealing with a colicky baby. Few people admit to having a colicky child because they are feeling insecure and alone too. However, you should look for others who are in the same boat as you are. Colic is something that happens to a lot of families and while it is hard to handle, you most certainly aren’t alone. You can even look for groups of moms with colicky babies online for someone to talk
to. Sometimes it is easy to feel like you are doing something wrong or that you are just nuts (”She only cries when she is alone with me!” or “Am I imagining this?”). This can be heightened by family who just doesn’t believe that your little angel is anything but, a little angel. You can get some relief. Leave the baby with the friends and family who don’t believe at the time time your baby is most colicky. Do some errands, take a break, and make it work for you. You won’t feel so alone and you will be sure to find it isn’t just you and you aren’t crazy! While colic isn’t necessarily something wrong with the baby, it sure can feel like it is and as such can make it feel like you have done something wrong.

You may blame yourself or search for something that happened during your
pregnancy or that you are doing wrong that may have “caused” this problem. While
researchers don’t know what causes colic, they do know that it isn’t you. Mom’s
everywhere may feel a little guilty, but they don’t have a right to be. There is
nothing that you could have done to make your baby colicky.

When I was eight months pregnant a very kind woman was talking to me about having the baby. She told me that at one time she was home alone and her daughter had been crying and crying. The crying had grated on her nerves and she suddenly thought about throwing her baby out of the window. She didn’t hurt her baby and felt guilty for thinking of that. When hearing this story I was appalled. I couldn’t believe that this woman was telling me this. She ended her story by telling me it was
okay if I had bad thoughts during a crying episode, as long as I didn’t act on them

In the hospital they showed a movie on shaken baby syndrome and I was amazed. How could people do that to beautiful babies? Then one day Marcus cried and cried and cried. I remembered both the story that was told to me and the shaken babies. While I could never shake a baby, any baby, I suddenly understood what prompted others to shake the babies and try and make the quiet. If you think, “I can’t take this anymore!”, if you yell at your baby, or you think bad thoughts you aren’t alone. It isn’t a good thing, but it is understandable. You should seek help if you need it (after all there are many psychological professionals who liken a colicky baby with post traumatic stress disorder). If you are thinking thoughts often, feeling like you might hurt yourself or your baby. Don’t feel ashamed to get help. However, it is fairly normal and if you just have an occasional thought just remember that you aren’t alone!Colic is a horrible thing to have to deal with. You should think ahead. After all, it isn’t going to happen forever. Over time you will find your baby outgrows the colic
and will soon become a little person, one you will probably like a lot more!

When we read a personal story, a narrative that explains one person's reaction, it can make a deeper impression than all the facts in the world: this Scientific American article helps explain why our brains value the evidence provided by compelling anecdotes over evidence produced by the scientific progress...

The reason for this cognitive disconnect is that we have evolved brains that pay
attention to anecdotes because false positives (believing there is a connection
between A and B when there is not) are usually harmless, whereas false negatives
(believing there is no connection between A and B when there is) may take you
out of the gene pool. Our brains are belief engines that employ association
learning to seek and find patterns. Superstition and belief in magic are
millions of years old, whereas science, with its methods of controlling for
intervening variables to circumvent false positives, is only a few hundred years
old.

The Washington Post reports that the EPA has updated its assessment of the value of a human life.

Someplace else, people might tell you that human life is priceless. In Washington, the federal government has appraised it like a '96 Camaro with bad brakes.

Last week, it was revealed that an Environmental Protection Agency office had lowered its official estimate of life's value, from about $8.04 million to about $7.22 million. That decision has put a spotlight on the concept of the "Value of a Statistical Life," in which the Washington bureaucracy takes on a question usually left to preachers and poets.

The Consumer Product Safety Commission isn't quite as impressed:

An example of this kind of analysis was used by the federal Consumer Product Safety Commission this year:

A proposal to make mattresses less flammable was expected to cost the industry $343 million to implement. But, a spokeswoman said, the move was also expected to save 270 people. The commission calculated that each life was worth $5 million, which meant a benefit of about $1.3 billion.

That was greater than the expense, she said, so the move made sense.

So, let's see what the cost benefit would be if an effective hospital education for new parents was nationwide and reduced the estimated 300 SBS related deaths by 50%: using the lesser CPSC value, the benefit would be $750,000,000.

The estimated cost of implementing education nationwide ($10 per birth): $41,000,000

The net benefit: $7000,000,000 in savings, even before adding in the costs of prosecuting and incarcerating the perpetrators in those cases.

And before adding in the medical, rehabilitation and educational costs associated with a comparable reduction in the 600 to 900 cases a year where children survive with significant trauma that requires significant caregiving and results in physical and cognitive disabilities (especially learning disabilities that require 12 years of special education costs). Plus even greater costs for prosecution.

And before adding the costs of those children with unrecognized cases of inflicted injury - "mild TBI" - and the resulting costs of special education.

So, spend $41 million, save more than $1 billion.

Not a bad return on investment...

Let your congressional representative know that the SBS Prevention Act also makes compelling economic sense

This isn't really SBS related, but the Daddytypes.com blog had an interesting post on design awards for a baby bottler holder and a baby pram.

In one case, they did something useful and in the other, they didn't...

As anything which makes caring for a child more frustrating can increase the potential for a parent or caregiver to lose control - frustration is cumulative - I suppose good - and bad - design is related...

Below, a good op-ed by Senator Chris Dodd, who introduced the Shaken Baby Prenvention Act (S. 1204). It ran in the New Haven Register in 2007, but unfortunately remains just as cogent today.

Senator Dodd: Stopping Child Abuse Before It Starts

May 25, 2007

Two-month-old Amanda was in grave danger from the day she was born. Her mother, a Connecticut resident, had a long history of physically abusing her children; she had already lost custody of nine of them. But Amanda was a newborn, and protective services couldn’t save her. On January 23, 2006, her 2 a.m. hunger cries enraged her father; and Amanda’s mother only looked on as he viciously took her life.

While Amanda is now beyond our power to protect, let’s remind ourselves that we still have the means to defend children like her—to stop abuse before it starts. True, the task is a daunting one: Numbers released last month by the Department of Health and Human Services reveal that nearly 900,000 American children were abused or neglected last year. We don’t know how many more thousands of victims were hidden from the child protective services. But we do know that abuse or neglect killed almost 1,500 children last year. And the youngest, like Amanda, suffer most: More than three quarters of those killed were younger than four.

Each year we spend billions to protect those children who have been so injured, so endangered that home is no longer safe. No one grudges that expense. But fighting child abuse is a lot like fighting sickness: We can pay exorbitantly to fight the advanced symptoms of disease, or we can seek preventive medicine. In far too many cases, we choose the first approach—and we wait to step in until the abuse has boiled over.

A preventive approach would require the work of whole communities. Government, teachers, businesses, doctors, clergy, friends, neighbors—they would all have a role to play, working together to create communities that care about children and offer parents the resources they need. We know that reducing the pressures on parents makes abuse much less likely: A 2005 study by the National Center on Child Abuse and Neglect found a link between parental stress and child maltreatment.

Those services—like home visits, respite care, and parent support groups—can help parents solve problems before they become crises. Rather than intervening when it may be too late, preventive services aim to strengthen families from the start. Primary medical checkups, for instance, don’t just keep children healthy and immunized—they help parents learn how to care for their children. Respite care doesn’t just keep children secure—it helps moms and dads deal with the inevitable stress of parenting. Above all, preventive services draw parents into a sense of community and belonging, giving them the tools to navigate an often isolating environment.

One outstanding effort is the shaken baby prevention program led by the Connecticut Children’s Trust Fund. The Children’s Trust Fund raises awareness of this deadly form of child abuse by offering home visits, educational programs in schools, and videos for new parents in hospitals. And a bill I’ve introduced—the Shaken Baby Syndrome Prevention Act—would strengthen efforts like those by launching a nationwide prevention campaign.

With this new, forward-looking approach, communities across America are pioneering similar family-friendly strategies to keep abuse down:

Organizing support groups for new parents;
Offering paid or unpaid family leave for the birth of a new baby;
Promoting volunteerism to assist early childhood programs in the community;
Seeking on-site child care or child care vouchers from employers;
Developing partnerships with local Head Starts, Boys and Girls Clubs, and other community programs serving young children and their families.

But services like these are just the first small steps—truly preventing child abuse will require a much larger effort.

Let’s be honest: It will cost us up-front. But all good investments do. We can pay comparatively little now for child abuse prevention: early-childhood programs, assistance to new parents, and community-based help for overburdened families. Or we can pay much more for the aftermath of abuse: protective services, foster care, law enforcement, courts, prisons, and treatment for adults recovering from abuse. To any smart investor, the choice is obvious.

But compassion compels our choice, as well. When we wait for abusers to make the first move, children like Amanda suffer; all too often, they die. For the sake of their memory, the first move must be ours.

Summer reading, part III - Prevent Child Abuse America makes it easy to support the Education Begins At Home Act.

April 1, 2007

Preventing harm requires two things: knowing what NOT TO do, and knowing what TO do -the "do's" and the "don'ts".

Hospital education about SBS does the first. There is clear evidence that home visiting programs do the second [including this recent RAND report]. This legislation will help expand home visiting programs.

From PCAA's Prevention Advocate

Take Action on the Senate Home Visitation Legislation
Ask Your Senators to Cosponsor S. 667

Please ask your Senators to cosponsor the Education Begins at Home Act (EBAH, S. 667), recently reintroduced in the Senate by Senators Kit Bond (R-MO) and Hillary Clinton (D-NY). EBAH would establish the first dedicated federal funding stream to support parents with newborns and young children through quality, voluntary home visitation. If enacted, EBAH would extend to a broad range of families the opportunity to benefit from home visiting programs like Healthy Families America. Making quality home visitation programs more widely available in all communities is one of Prevent Child Abuse America’s top priorities.
As of March 27th, the following Senators have already joined Senators Bond and Clinton as cosponsors to S. 667: Senators Jeff Bingaman (D-NM), Benjamin Cardin (D-MD), Susan Collins (R-ME), John Kerry (D-MA), Claire McCaskill (D-MO), Pat Roberts (R-KS) and John Rockefeller (D-WV). If your Senator is on this list, please be sure to thank him/her.

TAKE ACTION NOW

Why Congress Should Pass EBAH:

Home visitation is an effective, evidence-based, and cost-efficient way to bring families and resources together and help families to make choices that will give their children the chance to grow up healthy and ready to learn.
Home visitation delivers parent education and family support directly to parents with young children in their homes providing guidance on how parents can enhance their children’s development from birth through kindergarten entry.
Quality early childhood home visitation programs lead to proven, positive outcomes for children and families, including improved child health and development, improved parenting practices, improved school readiness, and reductions in child abuse and neglect.
Existing home visitation programs like Healthy Families America serve only a small percentage of families in need of prevention and family support services. EBAH dollars would enable programs to reach thousands more families who have very young children -- the same cohort of children that suffers disproportionately from abuse and neglect in this country.
Take Action on EBAH!
Take action by e-mailing your Senators through Prevent Child Abuse America’s Legislative Action Center. Prevent Child Abuse America has created a sample e-mail asking Senators to cosponsor EBAH that we encourage you to personalize. All Senators can (and should) be asked to cosponsor the EBAH. Support from the Senate Health, Education, Labor and Pensions (HELP) Committee is crucial, however, because it has jurisdiction over the legislation and can move EBAH forward.

Democrats
Edward M. Kennedy (MA), Chair
Christopher J. Dodd (CT)
Tom Harkin (IA)
Barbara A. Mikulski (MD)
Jeff Bingaman (NM)
Patty Murray (WA)
Jack Reed (RI)
Hillary Rodham Clinton (NY)
Barack Obama (IL)
Sherrod Brown (OH)

Independent
Bernard Sanders (VT)

Republicans
Michael B. Enzi (WY), Ranking Member
Judd Gregg (NH)
Lamar Alexander (TN)
Richard Burr (NC)
Johnny Isakson (GA)
Lisa Murkowski (AK)
Orrin G. Hatch (UT)
Pat Roberts (KS)
Wayne Allard (CO)
Tom Coburn

It's summer - time for some reruns...

A reminder about the SBS Prevention Act of 2008

April 28, 2007
SBS Prevention Act of 2007 - Support
By geolith

The Shaken Baby Prevention Act of 2007 was introduced in Congress this week: Senate bill S.1204 (Dodd) on Wednesday -House bill HR 2052 (Lowey) on Thursday. It's a first: a national awareness and education initiative to prevent Shaken Baby Syndrome and other inflicted head trauma.

Some suggestions for garnering support:

- email and call your Senators and your Representative. Ask them to "cosponsor" those bills [not just to "vote" for it if it gets to the floor: the more cosponsors, the speedier a bill goes from committee to the floor].

- engage local and state elected officials. Ask them to contact federal legislators and urge support.

- begin some "buzz": visit websites of the local papers in your area and write a letter to the editor to let people know why it's a good idea; contact journalists who cover SBS cases; post to blogs read by parents; if you have educated a group about SBS, ask them to write their legislators and tell them why they should support prevention education.

- email friends and relatives, especially in other states, asking that they email their federal legislators and ask for support.

And please email Senator Dodd and Congresswoman Lowey thanking them for their initiative.
Dodd: http://dodd.senate.gov/index.php?q=node/3128&cat=Opinion
Lowey: http://www.house.gov/lowey/get_address.htm

Contact info for federal legislators:
www.congress.org
http://www.vote-smart.org/index.htm

For the text of the bills
http://thomas.loc.gov/bss/d110query.html search [shaken]

[110th]H.R.2052 : To enhance Federal efforts focused on public awareness and education about the risks and dangers associated with Shaken Baby Syndrome.
Sponsor: Rep Lowey, Nita M. [NY-18] (introduced 4/26/2007) Cosponsors (33)
Committees: House Energy and Commerce
Latest Major Action: 4/26/2007 Referred to House committee. Status: Referred to the House Committee on Energy and Commerce.

[110th]S.1204 : A bill to enhance Federal efforts focused on public awareness and education about the risks and dangers associated with Shaken Baby Syndrome.
Sponsor: Sen Dodd, Christopher J. [CT] (introduced 4/25/2007) Cosponsors (8)
Committees: Senate Health, Education, Labor, and Pensions
Latest Major Action: 4/25/2007 Referred to Senate committee. Status: Read twice and referred to the Committee on Health, Education, Labor, and Pensions.

From their joint announcement of introduction

Senator Chris Dodd (D-CT), a senior member of the Senate Health, Education, Labor, and Pensions Committee, and the Chairman of its Children and Families Subcommittee, today introduced the Shaken Baby Syndrome Prevention Act of 2007.

Shaken Baby Syndrome (SBS) describes the trauma resulting from the violent shaking or abusive impact to the head of an infant or young child. SBS is a form of child abuse affecting between 1,200 and 1,600 children every year, of which between one-quarter and one-third will die and another one-third will suffer permanent, severe disabilities. Senator Dodd’s legislation would establish a national public health campaign to raise awareness about SBS, encourage prevention programs and provide preventative support for parents and caregivers, and provide support to families affected by abusive head trauma incidents. Congresswoman Nita Lowey (D-NY) introduced companion legislation in the House of Representatives.

“Young children are America’s most vulnerable citizens, and it is our responsibility to do everything in our power to protect them,” said Dodd. “Shaken Baby Syndrome is completely preventable, and I am hopeful that by educating parents, caregivers and the general public about the dangers of shaking a child, we will be able to eliminate this form of cruel and senseless abuse from our society.”

“Shaken Baby Syndrome tears apart families and impacts the lives of thousands of young children each year," Lowey said. "However, with better education for parents and other caregivers, we can dramatically curb this horrible form of abuse.”

Posted on: Sat, Apr 28 2007 5:32 AM

Babyzone features an excerpt from The Colic Chronicles, an insight into the world of a mom coping with a colicky baby and post-partum depression.
[Update - Mama Speaks also has a good review...]

It's an important perspective to share with new parents: colic is cited as a key precipitating factor in many shaking cases, and the feelings of failure, isolation and depression that accompany PPD makes caregiving harder for all of the family.

Knowing that others have dealt with the same issue, and learning about their coping techniques, can't help but put things into better perspective.

So many books today focus on soothing the baby but what about the poor soul who is trying to care for that baby! That is where The Colic Chronicles comes in. Tara shares some helpful hints, professional advice, and important mommy self-care tips and delivers all in a fun and easy-to-read style. Included in the appendix is a copy of "The Colic Commandments," a colic countdown calendar, and numerous references for making mom's life easier.

http://www.thecolicchronicles.com/

PS. I do wish that Babyzone included some reminders in its checklist that parents need to talk to other caregivers about colic (and teething, vaccinations, etc.), the feeling of frustration and anger that can result and help them prepare a coping plan.


Disclosure: when the book was in progess, we discussed the links between SBS and colic with the author, Tara Kompare. She is generously making a contribution to the SKIPPER Initiative.