Discover magazine has a thought-provoking article on the question of whether ‘shaken baby syndrome’, claimed to be a specific type of brain damage that occurs to young children if shaken, actually exists as a useful syndrome. If it doesn’t, it might not only be a medical miscategorisation but also a legal disaster that may have falsely convicted innocent families of child abuse.
Critics argue it’s a bit like calling a broken nose ‘punched in the face syndrome’. The label is for a non-specific injury but which automatically leads us to assume that an aggressor must exist.
Once a doctor says that an infant must have been shaken, it triggers a hunt for the shaker. In one diagnostic step, the legal system is brought to bear on the baby‚Äôs family and anyone else near the infant at the time of the supposed shaking.
The symptomatic triad of bleeding between the brain and skull (known as subdural or subarachnoid hematomas), bleeding behind the retinas, and brain swelling is both the core of an SBS diagnosis and the point of departure for the syndrome‚Äôs skeptics. The medical proof that shaking alone can cause these internal head injuries is questionable, the skeptics say, when many other things, from infections to malnutrition to falls onto a hard surface, are known to be causes of similar symptoms in infants.
In contrast, supporters of the condition, which came to world-wide attention in the case of British nanny Louise Woodward, argue that shaking causes babies specific injuries that are unlikely to be triggered by anything else. The article quotes Eli Newberger, an assistant professor of pediatrics at Harvard Medical School:
‚ÄúBy the time I was asked to testify in the Louise Woodward case…there was a great deal of clinical understanding about [SBS-related] trauma,‚Äù Newberger says. ‚ÄúThe infant‚Äôs head is disproportionately larger in relation to the rest of its body than our heads are. A child can‚Äôt stop the to-and-fro excursions of the head with its neck. The brain bobbles about. The infant‚Äôs brain is softer than the adult‚Äôs.‚Äù…
Money, Newberger suspects, has brought otherwise good people over to what he and his colleagues call the ‚Äúdark side,‚Äù doubting SBS. ‚ÄúI have never ceased to be amazed about what highly regarded, well published, scientifically informed doctors will do when they‚Äôre offered large amounts of money,‚Äù he says.
And indeed, experts on both sides seem to charge a great deal for their time.
The article walks us through some of the studies that have attempted to look at how many children with these symptoms show other signs of abuse, or have tried to simulate the damage with computer or physical models.
It’s a fascinating look at a syndrome I just took for granted as being widely validated and looks at the implications of the scientific work for the legal system, where incorrect diagnosis can lead to abusers going free or loving parents being jailed.
Link to ‘Does Shaken Baby Syndrome Really Exist?’.