Twin Cities Metro Shaken Baby Syndrome Prevention Program

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Shaken Baby Syndrome (SBS) represents the most severe form of child abuse and accounts for the majority of severe head injuries in children less than 1 year of age, with a 15-35% mortality and half of survivors suffering permanent neurological damage leading to blindness, seizures, developmental delays, and spasticity. It is estimated that 1400 children die of abusive injuries in the United States each year, and most deaths are attributed to severe head injuries. Violent infant shaking is most commonly a response to persistent infant crying by a caregiver; nearly three-quarters of perpetrators are parents, and 60% are males (fathers and father figures).

A promising SBS prevention program began in Upstate New York in December 1999. The purpose of this program is to provide SBS education to both parents (mothers and father figures) of all infants born in an 8 county region of Western New York before discharge from the hospital. The premise was that parents needed to be reminded at the correct time (upon the birth of a child) about SBS, and that educated parents could be effective advocates in disseminating this information to all that care for their child. Under the program, parents receive both written and video materials about SBS before leaving the hospital. Both parents are then asked to voluntarily sign a commitment statement affirming their receipt and understanding of this material; these commitment statements are returned and tracked by the investigator.

The initial results of this education program are noteworthy. The program tracked the incidence of SBS in the 8 county upstate New York regions from December 1998 to December 2001, comparing it with historical SBS incidence figures form the 6 preceding years. The program demonstrated a sustained and consistent 63% reduction in incidence in these 8 counties during the program. Subgroup analysis suggests that at least 5 and perhaps 7 of the 8 cases born during this period were in families that did not receive this information.

A collaborative group of Twin Cities child abuse professionals, the Twin Cities Metro SBS Prevention Task Force, has been meeting at Midwest Children’s Resource Center (MCRC) since December 2001 to research and develop an approach to bring similar results to the families of the Twin Cities metro region. The hope is to engage, educate and support new families with this timely message in order to reduce the incidence of SBS. The goal is to rollout this initiative in early 2003 to all birthing hospitals of the 7 counties in the Twin City metro region.

The TC Metro SBS Prevention Program will replicate the aforementioned Buffalo/Dr. Dias model. A nurse or trained volunteer will provide the SBS education (‘Babies cry…’card, 11 minute video “Portrait of Promise-Preventing SBS”, and Commitment Statement) during EVERY family’s postpartum stay. The commitment statement describes the education as voluntary, but encouraged. The demographic data requested will be used for tracking of program participants and reported in future papers as numbers, not identifying names.

Minnesota Department of Health is collaborating with this program by establishing a baseline incidence of SBS in MN via abstracting medical records of TBI with probability of AHT (the TC Metro Task Force met with MDH to confer and agree on discharge codes with a high probability of AHT.) At the end of each program year, MDH will report SBS incidence based on the same identified codes to see if incidence changes during the implementation of this education initiative.

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