By Vanessa Papas: The horror of Shaken Baby Syndrome: By the time paramedics arrived Dominic Allen’s body was limp and lifeless. The seven-week-old baby boy was rushed to hospital where a brain scan revealed internal bleeding. The following morning, Dominic’s heart started to slow. He was pronounced dead 15 minutes later. An autopsy showed he had a three centimetre bruise to the back of his head and brain haemorrhaging. Evidence pointed to ‘shaken baby syndrome’. Dominic’s mom’s boyfriend later admitted he suffered a sudden loss of control and vigorously shook Dominic because he wouldn’t stop crying.
Ask any parent and they’ll tell you an inconsolable baby, especially one in the middle of the night, when your head is aching from a long day and a string of sleepless nights have taken their toll, has the ability to drive you crazy. Many parents, especially those who are young and inexperienced, are left in a state of shock and absolute stress when faced with a hysterical bundle. Although shaking a child and damaging its little body is unacceptable; Shaken Baby Syndrome has become increasingly common in South Africa.
Shaken Baby Syndrome refers to the violent and repetitive shaking of an infant or toddler usually under the age of two, and is a form of abusive head trauma. It was first described in 1974, and has since been the topic of intensive study and discussion. The syndrome has classically been diagnosed with a triad of injuries, namely subdural haemorrhage, retinal haemorrhage and encephalopathy (brain abnormalities). Young children are extremely susceptible to sustaining injuries from shaking due to their particular physical vulnerabilities, like heavy heads, weak neck muscles, thin skull walls and soft and rapidly growing brains. The morbidity and mortality rates from shaking are high; it is suggested that only 15 percent survive with no lasting morbidity, and survivors are said to suffer from physical disabilities, neurological impairments and long-term behavioural problems, including survivors of SBS may require lifelong medical care for conditions such as partial or total blindness, hearing loss, developmental delays, learning problems or behaviour issues, mental retardation, seizure disorders and cerebral palsy.
To date, no reported case law is available on SBS in South Africa. A database compiled by The Medill Justice Project in 2014, however, highlights the numbers of ‘potential’ shaken baby cases. Pretoria has the highest reported cases with nine, followed by Johannesburg with three, Durban with two and Paarl with one. Figures for other provinces could not be established.
Garry Hertzberg, practicing attorney at Dewey Hertzberg Levy Attorneys and presenter on The Laws of Life says a few recent cases of shaken baby syndrome (and abuse) include Baby Michael who was shaken to death by his parents, Baby Christina whose parents are accused of abusing her to the point of disability and Baby L who was abused to a point that she is now in a vegetative state.
In 2003, Baby Michael was throttled, punched in the head and shaken with such brutal force that he was left blind and brain dead. He died in a home two years ago. His parents were sentenced to an effective 10 years each for the crime last year. Baby Christina suffered broken legs, ribs and a fracture in her skull, leaving her with vision problems. Her parents were charged with trying to shake the life out of her, hanging her out of a window of their apartment, suffocating her with a pillow and nearly drowning her in a bath of water. Baby L was already in a coma when she was rushed to the Akasia hospital on 30 December 2014. Parts of her brain had already died and she had a fractured hip, blood in her abdomen and fluid in her lungs from a near-drowning. She also had a bruised kidney, a serious injury to her pancreas as well as old and new bruises all over her body. Baby L is now in a vegetative state in an institution, unable to feed herself, walk or talk.
Although shaking a child and damaging its little body is unacceptable; SBS has become abnormally common in South Africa,” explains Garry. “It is believed that SBS is quite common. Only now that autopsies are done on babies, have people realised that many ‘cot deaths’ are actually SBS. Although many parents think it is fun to throw their babies up and down, shake them on their laps or put them on a swing, it is actually quite dangerous. Babies have not developed any neck muscles and cannot support their heads.”
Luke Lamprecht is a long standing advocate for child protection and Development officer for the Shaken and Abused Baby Initiative (an advocacy programme aimed at raising awareness of the diagnosis) as part of the Teddy Bear Clinic for Abused Children. He says there are numerous causes of SBS across the globe, and many cases in SA. In 99 percent of cases both parents are involved. What makes SBS such a complex topic, is that number of medical issues, such as the bone condition and rickets, for example, can mirror symptoms of child abuse. A child who’s been forcefully shaken may need to be examined by a number of medical specialists, as well as an expert in child abuse. Which is why a case of potential SBS sometimes calls for upwards of 20 tests to correctly diagnose abused children.
“In terms of recording and numbers, it’s very, very poor, and I think we still suffer from under-diagnosing rather than over-diagnosing,” Luke explains. “The law in South Africa needs to be better equipped to prosecute abusive parents and caregivers. The current legal response is not sufficient. We need very serious professionals and good people leading police prosecutions who understand the issue, and good social workers who stand their ground and don’t accept that the child ‘fell’.
Did you know?
Children less than one-year-old are the most at risk of SBS because they cry more often, but older children can also be seriously injured if they are shaken violently. No child, at any age, should ever be shaken.
Why Is My Baby Hysterical?
Most babies cry two to three hours a day for the first two to three months of life. 15h00 to midnight is often a fussy time. Check to see whether the crying is a signal that your baby needs something specific, like a nappy change, feeding, relief from being too hot or too cold, attention, or has a fever. Wrapping or swaddling your baby in a soft blanket or playing soft music, white noise or a gentle shushing noise can soothe some babies. Many babies are soothed by motion. Try walking with baby in a sling or in a stroller. Rock or sway with baby in a gentle, rhythmic motion. Sucking sometimes helps babies to calm and relax. You can provide this by allowing your baby to breastfeed or by offering a pacifier. If your baby continues to cry after you’ve made sure there’s no specific problem, try to stay calm and be aware of how you feel. Take a moment to relax. If you think you might be struggling with depression, or know someone with a new baby who is, talk to your health care provider.
How To Keep Calm
- Put the baby down
- Ask someone to watch the baby
- Try gently rocking the baby, or give them a pacifier or a bottle.
- If you heat up then put the baby down
- Eventually, you will calm down
- Not all situations are simple so go step by step to figure them out
- Control your anger
- Exit the house, take baby for a ride
If a child you know is being abused, contact the following groups:
* Childline SA Toll-free number: 0800 055 555 or Gauteng: (011) 645-2000
* The Teddy Bear Clinic: (011) 484-4554/4539/083 557 3720 ttbc.org.za