In 1972, Dr. John Caffey through his article "On the Theory and Practice of Shaking Infants" brought to the forefront the issue of shaken baby syndrome, a serious form of child abuse resulting in permanent brain damage for children primarily under the age of 1 year. At that time, Dr. Caffey also called for a nationwide education effort to educate the public about the dangers of shaking babies. However, it was not until 1989 that studies began in Ohio and then expanded to five surrounding states. These studies focused on the lack of public knowledge about the dangers of SBS and collected feedback from parents as to the benefits of receiving SBS information. Dr. Jacy Showers published the results of these studies in 1992 and reported that 25-50% of teenagers and adults did not know that shaking a baby could be dangerous.1 In addition, parents receiving information about SBS reported that it was helpful and 51% said they were less likely to shake their babies after reading the information.2  In 1992, armed with such promising data on the effects of SBS education, the National Center on Child Abuse and Neglect (NCCAN) funded a three year project entitled "Don’t Shake the Baby." Funds were given to all fifty states, including Washington DC and Puerto Rico, to either begin SBS education programs or to expand them. Thus, the first national SBS public awareness campaign lead by "Don’t Shake the Baby" state contacts. Primarily beginning in 1996, Children’s Trust and Prevention Funds, National Committee to Prevent Child Abuse,   and   Parents Anonymous also joined in the SBS prevention effort. When NCCAN funding ended in 1995, some agencies continued on in SBS prevention while others abandoned it altogether. The remaining agencies, however, continued to provide education through a variety of media and community workshops while trying to operate with limited funding.

Most of the initial prevention efforts focused on educating new parents, but over the past couple years, more emphasis has been placed on the male population, which is considered one of the highest risk groups. Education typically includes information on the dangers of shaking babies, signs and symptoms of SBS, and ways to cope with a crying baby along with information about crisis hotlines to utilize in the event they felt they may potentially shake a child. In addition, positive parenting practices have been emphasized in agencies such as Parents Anonymous. However, there still remains a need to educate many other groups with the same intensity, including professionals in the areas of child care, social services, medicine, and law to name a few. Specifically, physicians need medical training on abusive head trauma, including recognition of early signs and symptoms so children are spared from serial shaking.3 Child care providers, another concerning risk group, need to have mandated child abuse training that includes SBS education before they begin caring for children.

The mode of delivery of educational materials has varied, but has primarily been through one page brochures or flyers. Most agencies have developed curriculums and have utilized trained volunteers to go out into the community to spread SBS prevention information to every segment of the public, including school aged children. Many families touched by SBS have become involved in prevention volunteer activities either through agencies or on their own.

Funding for prevention continues to be limited although the benefit of prevention can far outweigh the cost of care for a surviving SBS child over their lifetime. It has been estimated that just the initial hospitalization for a SBS child is $75,000-$95,000. 4 This does not include continuing rehabilitation or medical expenses incurred after the child goes home. Most of these costs are absorbed by society through insurance, government assistance, and increased special education costs.

Prevention efforts to educate remain the key component in decreasing the incidence of SBS. SBS support groups and others can help in some way, big or small. Parents, child care providers, and other caregivers are encouraged to educate others by printing out  the dangers of shaking babies, signs and symptoms of SBS, ways to cope with a crying baby, and crisis hotlines  information on this website and have the individual receiving the information review it and then obtain an acknowledgement of receipt of shaken baby syndrome information from them stating they have reviewed the material and understand the dangers of shaking babies. Volunteering at a local agency with a SBS prevention program is another way to help educate the public as well as soliciting donations for a SBS prevention agency, either through individual or corporate contributions. Political activism to initiate and support legislation mandating that hospitals inform parents of the dangers of shaking babies and that schools educate on the middle and high school levels about the dangers of shaking babies. In addition, legislation that requires that child care providers complete a child abuse course, including information on the dangers of shaking babies, before they begin caring for children.   Legislation should be backed by a plan for funding up front so that programs are not created by law, but unable to accomplish their objectives due to lack of funding.

FOOTNOTES
1,2 Dr. Jacy Showers. "Shaken Baby Syndrome: The Problem and a Model for Prevention," Children Today, 21 (1992), 35-37.

3 Dr. Jacy Showers. The National Conference on Shaken Baby Syndrome: A Medical, Legal, & Prevention Challenge, Executive Summary (Alexandria, VA.: National Association of Children’s Hospitals and Related Institutions, 1996), p. 10

4 Ibid, p. 28

BIBLIOGRAPHY
Showers, Jacy Dr. The National Conference on Shaken Baby Syndrome: A Medical, Legal, & Prevention Challenge, Executive Summary. (Alexandria, VA.: National Association of Children’s Hospitals and Related Institutions, 1996)

Showers, Jacy Dr. "Shaken Baby Syndrome: The Problem and a Model for Prevention," Children Today, 21 (1992).

Prevention," The Shaken Baby Alliance (www.shakenbaby.com), 1999,
http://shakenbaby.com/frameset_prevention.htm

A special thank you  to Dr. Jacy Showers, (SBSPreplus@aol.com), SBS Prevention Plus, who provided input for this section.

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