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FNS Photo by Dave Wallis Elizabeth Oestreich, child injury prevention coordinator at Sanford, holds a demonstration doll that has a clear plastic skull to show the brain when it is shaken.

‘Caring hands’ for infants: Campaign aims to limit shaken baby syndrome

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FARGO — A new program here is aiming to prevent the most common, yet difficult to pinpoint, form of physical abuse inflicted on babies and children.

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The challenge in getting the message out, however, is determining to whom it should be targeted.

Kohl’s Caring Hands is taking on shaken baby syndrome, or SBS, by giving parents and caregivers the tools for staying calm when a baby is crying.

The program started up a few months ago with a nearly $38,000 check to Sanford Children’s Hospital from Kohl’s department stores in Fargo and Grand Forks.

According to Sanford, 55 babies and children have been hospitalized there over the past five years because of SBS-type injuries. Many of those children are suffering lifelong disabilities, including blindness or cerebral palsy.

It’s a serious, sometimes deadly injury that doesn’t have to happen.

“One split-second move can affect that baby for the rest of its life,” said Elizabeth Oestreich, child injury prevention coordinator at Sanford.

Getting message out

Oestreich was hired for the program in November and has since immersed herself in working to get the word out. She said a parent or caregiver shaking a child can happen in any socioeconomic status or family situation.

“We can’t look in a crowd and say, ‘You are going to shake your baby,’ because a lot of it is that loss of control; they are stressed out,” Oestreich said.

She’s focused on creating educational tools, which are so far being promoted in local cable ads and in bathroom stalls of local bars — an effort to reach a younger population.

“We’re just trying to flood the community with knowledge,” Oestreich said.

Part of the message is reinforcing the fact that all babies cry, some more than others. The most intense periods of crying for babies are from 6 weeks to 4 months of age.

The program offers tips to calm your baby and yourself, and if those don’t work, the consent to put your baby in a safe place and walk away to take a break.

The mantra Oestreich wants people to remember is “Stay Calm, Walk Away, Call a Friend.”

True count difficult

Last year, Sanford Children’s Hospital in Fargo treated 12 children for nonaccidental head trauma that occurred during proven cases of physical abuse or assault.

The number could be higher, however, because there are a handful of cases still under investigation.

According to the Sanford Health Trauma Services Registrar, if a caregiver said the injured child fell down the stairs, the patient is listed that way in the registry until there is documentation that proves otherwise.

Another difficulty in coming up with firm numbers is the numerous causes of bleeding in the brain, a red flag for head trauma.

In addition to accidental and nonaccidental causes, there can be genetic or medical reasons, according to Dr. Arne Graff, child abuse pediatrics consultant at Sanford.

“There are times it’s very difficult to determine the (cause of the) simple presence of blood inside the head,” Graf said.

In some cases, the child simply looks ill and may be vomiting. In other cases, symptoms may be very subtle.

Because of those intangibles, there is no true national database for inflicted head trauma.

The National Center on Shaken Baby Syndrome in Farmington, Utah, with the website dontshake.org, is the closest thing to it.

Based on research, the center estimates 1,300 children in the U.S. experience severe head trauma from child abuse each year. In about 20 percent of those cases, the child dies.

Those who survive can face profound mental and developmental disabilities, blindness or paralysis.

A November 2013 study in the Journal Pediatrics examined child hospital discharge data nationwide and applied a new coding algorithm developed by the Centers for Disease Control and Prevention.

It found the highest rates of abusive head trauma in children under the age of 1 to date.

It also found the Midwest region had the highest rate, with as many as 48.1 cases per 100,000 children, while the Northeast had the lowest rate, with as many as 29.1 cases per 100,000 children.

The authors did not offer any conclusions as to why.

However, Graff said research has shown that child abuse clearly parallels economic downturns.

“People are stressed, they act on impulse,” he said.

Taking a team approach

According to Graff, the only follow-up for a child with head trauma 30 years ago was with their primary care provider.

Now, a team approach is used, including neurologists and physical, occupational and speech therapists.

In addition to treating head trauma patients in Fargo, Graff has patients in Grand Forks, Williston, Dickinson, South Dakota and western Minnesota.

“It’s a great cooperative effort, with multiple medical entities,” Graff said.

Social workers, police and prosecutors also play vital roles.

“It takes a team to work with these kids,” said Graff, “and an even bigger team for prevention.”

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