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PROGRAM TO CUT CASES OF SHAKEN BABIES IS SET TO EXPAND

Efforts in Western New York to eliminate one of the most troubling forms of child abuse, shaken baby syndrome, have gone so well that doctors here plan to expand the program into Rochester.

"It's too early to say for sure, but the data is compelling," said Dr. Mark Dias, a specialist at Kaleida Health's Children's Hospital who started the initiative.

Standard procedure at hospitals with maternity units is to teach couples what to do with their newborns once they leave the hospital. But for the past 14 months, parents in the Buffalo region also have been learning what not to do -- never severely shake a baby.

Seventeen hospitals in the region have been handing new parents information on shaken baby syndrome separate from the standard package of material that theyreceive before going home with their newborn. In addition, both parents must sign an affidavit that they have read the information and answer a brief list of questions.

Only one infant has been reported with shaken baby syndrome since the program began in December 1998.

"This is the first study of its kind and the first to demonstrate that educational efforts can reduce the incidence of the syndrome," Dias said. "It could be a statistical aberration, but if it is, it's a wild one."

Shaken baby syndrome has received national attention because of a handful of celebrated cases, including the 1997 nanny murder case in Boston, Mass., involving Louise Woodward.

The Child Abuse Prevention Center's National Information, Support and Referral Service on Shaken Baby Syndrome estimates there are 600 to 1,400 deaths a year nationwide, and many more injuries.

But the statistics remain problematic because experts say that many incidents go unreported.

No one knows how many undiag-nosed shaken babies suffer disabilities, changed personalities or have learning problems, Dias said. Shaken babies may show subtle symptoms -- lethargy, vomiting or irritability -- that pass for other illnesses, he said.

Enclosed within the skull, the brain is a gelatinous material that floats in a protective sea of cerebrospinal fluid. This fluid supports the brain and acts as a shock absorber in rapid head movements. When a child is shaken, delicate veins between the brain and skull tear and bleed, according to medical experts. Blood pools between the skull and dura mater, the tough membrane next to the brain, and forms a large blood clot called a hematoma.

Picture a bowl of Jell-O. Jiggle the bowl and the Jell-O will separate slightly from the sides. Jiggle the Jell-O even harder and it will fall apart.

Similarly, experts say repeated whiplash slams and rotates the soft brain, tearing fragile blood vessels and cutting off needed oxygen to cells.

Dias and others said shake long and
hard enough, and a brain can turn to mush -- what medical experts call "black brain," in reference to the color of a badly damaged brain on a CT scan.

The regional program was funded by a grant from the William B. Hoyt Jr. Memorial Children and Family Trust Fund, which has agreed to continue funding it this year, when the program will expand into Rochester.

Rochester experienced 12 cases in 1999 after a roughly five-year period when it saw about five instances annually, Dias said.

Assemblyman Sam Hoyt, D-Buffalo, and state Sen. Patricia McGee, R-Franklinville, sponsored a bill that would amend the public health code to require information about shaking babies be given to all new mothers. Although the proposed legislation has not moved forward, Hoyt said the study may help persuade the Health Department to create an educational campaign.

"The study gives us ammunition for the argument that educating people about shaken baby syndrome works and saves money," he said.

Hoyt said he hopes Dias can duplicate the results and demonstrate significant savings for a condition that can incur immense medical bills.

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