don't shake!

by Elizabeth Martyn

Why is it crucial never to shake a baby? And what can you do when the crying won't stop...

image to accompany feature
© Daniel T. Yara

'Waaaagh!' The sound of a baby howling at full throttle slices through its parents like a chainsaw. Nature planned it that way. How else can a small, helpless creature grab the attention it needs to stay alive?

Crying is a very powerful means of communication, and one that babies use to great effect. But if a baby cries on and on, parents can be pushed up to – and beyond – the brink of endurance. And that's when violence becomes a real danger. A recent survey by the NSPCC found that six out of ten parents of babies and toddlers say they have hit their child. For each child, those blows are a form of abuse. For a fragile baby, they're potentially life-threatening.

the experts disagree

Babies are especially vulnerable to brain damage. Their weak neck muscles, coupled with their large, heavy heads, mean that if a baby is shaken, the head – and the brain inside the skull – moves violently. Tiny blood vessels are ripped and bleed into the brain, causing devastating damage such as deafness, blindness, fits and even death.

Shaken Baby Syndrome was first recognised in 1972. For many years, doctors and police were in agreement about the three unmistakeable signs that a baby had been shaken. If the brain was swollen, and there was bleeding on the surface of brain and behind the retinas of the eyes, it was enough to prove guilt.

But now, Shaken Baby Syndrome has become a medical and legal can of worms. Dr Jennian Geddes, a leading neuropathologist, has suggested that the crucial three symptoms don't prove shaking, because they could also be caused by a cut-off of oxygen to the baby's brain. That could happen if a baby chokes on a feed, or tumbles just a few feet.

Experts are in conflict over the whole issue: some doctors agreeing with Geddes, others strongly opposed to her views. The only certainty is that the three signs can no longer be used to prove that a baby has been shaken. To support that accusation, police now have to find other convincing evidence of abuse.

handle with care

If Dr Geddes is right, then it's even more vitally important to handle babies with the utmost care.

safe ways to hold a baby

Cuddled up to your shoulder, your hand supporting the head
Baby looking outwards, back against your body, your arm around baby's tummy
Lying securely on your chest
Cradled in your forearms, feet against your body, head supported by your hands
Carried in a baby sling
The most important thing to remember is this: always support a baby's head and neck carefully.

dangerous handling

Play that's too rough, gripping very tightly, shoving a dummy or bottle into baby's mouth
Frightening a baby by holding at arm's length, or picking up without warning
Throwing a baby up in the air could be dangerous, even in play
Never, ever, shake, even if you're afraid the baby isn't breathing. Flick the soles of the baby's feet, rock the cot, or pick the baby up with the head supported
If you do lose control and shake a baby, get medical help immediately. Delay could cause damage or death.

soothing a crying baby

Trying to calm a wailing baby can be exhausting and frustrating. Try these tactics:

Put your baby to the breast, or give a dummy to suck
Cuddle, rock or sway with baby in your arms
Sing or talk gently to the baby
Take the baby out in the pram or buggy, or for a drive
Distract with a mobile, toy, or game
Give a warm bath
Colic can cause lengthy evening crying. Your health visitor can suggest remedies
Babies cry if they're ill, so if the crying, or the way the baby looks or behaves, seem unusual, contact your GP.

strategies to help you cope

If the crying goes on and on, parents can start to feel desperate. Many who admit to having hit their small children say they lashed out because they were so angry. But it's vital that parents don't give in to their anger. If your feelings threaten to overwhelm you, try these sanity-saving strategies:

Put the baby safely into a cot or pram, and leave the room until you're calmer. The baby may carry on crying, but it's more important that you get a break.
Take turns with your partner to get through a baby's crying jag. When it's not your turn, take yourself right away from the noise.
Ask someone you trust to stay with the baby while you go out for a break.
If you're suffering from lack of sleep – and most new parents are – try every ploy you can to encourage your baby to sleep better. Read books, search the Internet, ask friends for suggestions.
Rest whenever you can. Say 'no' to other people's demands, and put your need for sleep high on the agenda.
Remind yourself that this phase won't last forever. By the time a baby reaches six months, the worst of the crying is usually behind you.
If every day is a bad day and you're struggling to cope, you might have postnatal depression, which affects as many as one in five new mums. Other symptoms are lack of energy, losing interest in your appearance, anxiety or panic, tearfulness and loss of concentration. Postnatal depression is a treatable illness, so see your GP or health visitor as soon as possible and ask for help.

If you're terrified of losing control, and desperate for someone to talk to, ring the NSPCC Child Protection Helpline on 0808 800 5000. Trained counsellors are on call 24/7 to give carers advice and support.

(June 2005)

Read on for details of relevant organisations, websites and reading.