FORT BRAGG, N.C. - Womack Army Medical Center has become one of the first hospitals in the state to implement an evidence-based shaken baby prevention program. This July, maternity nurses began sharing the program materials and message with parents of all babies born at Womack Army Medical Center before discharge.
Training and supplies were made available by Keeping Babies Safe in North Carolina, collaboration between the National Center on Shaken Baby Syndrome, the University of North Carolina Injury Prevention Research Center and the Center for Child and Family Health. The goal of Keeping Babies Safe in North Carolina is to reduce shaken baby syndrome in North Carolina by 50 percent over the next five years; this represents the largest and most comprehensive intervention for shaken baby syndrome in the country. The first step in this process is for all 90 hospitals in the state that handle deliveries to share the materials and message with all parents and caregivers of infants. This way, the program will reach every parent of the approximately 125,000 babies born in the state annually.
"In a baseline survey of parents of children younger than 2 years old in North Carolina, we found that more than 2,000 of these children are shaken, to a greater or lesser extent, by a caregiver each year and that serious injuries result for some," said Dr. Desmond Runyan, a professor of social medicine and pediatrics at UNC and a principal investigator for the project.
Nationally, an estimated 1,200 to 1,400 children a year receive medical treatment after being shaken. An estimated 25 percent of these children die and 80 percent of survivors are left with some form of life-long brain injury. "A lot more children are shaken who are not hospitalized but may have mental retardation or learning disabilities later. This shows the need for, and potential benefits of, preventing shaking," Runyan added.
The intervention being used is The Period of PURPLE Crying®, which was developed by Dr. Ron Barr, a professor of community child health research and a developmental pediatrician at the University of British Columbia, and Marilyn Barr, founder and executive director of the National Center on Shaken Baby Syndrome. Barr and Marilyn Barr are collaborating with the North Carolina project.
Barr created the concept of The Period of PURPLE Crying® to help describe the characteristics of crying in healthy infants. PURPLE describes normal infant crying, it peaks at 2 months of age and ends at 4 or 5 months and often earlier. It is unexpected, resists soothing, the child appears to be in pain, it is long (lasting two to five hours) and occurs more in the evening. The word "period" lets parents know that this experience of increased, frustrating crying is temporary and eventually does come to an end.
The program includes hospital and health care provider-based parent education, a 10-minute video and an 11-page booklet that parents can share with other caregivers of their baby, such as family members and babysitters. The program educates parents and caregivers about the hazards of shaking and gives them alternatives to use when they feel they- need a respite from a crying baby. For example, they can hand off the baby to another caregiver or go to another room while leaving the baby in its crib with the rails up for periods of no longer than 15 minutes.
Keeping Babies Safe in North Carolina has received about $7 million from the Centers for Disease Control and Prevention, the Doris Duke Charitable Foundation and the Duke Endowment and is led by a broad coalition of stakeholders from the National Center for Shaken Baby Syndrome, University of British Columbia and state and county agencies, service providers and non-profit organizations.
(Editors note: Runyan can be reached at (919)843-8261 or drunyan@unc.edu. The Center for Child & Family Health contact is Kelly Sullivan, (919)419-3474 ext. 254 or kelly.sullivan@duke.edu.)
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