Jewish World Review Oct. 29, 2004 / 14 Mar-Cheshvan 5765

Drs. Michael A. Glueck & Robert J. Cihak

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New Scientific Evidence Refutes Existence of Shaken Baby Syndrome


http://www.NewsAndOpinion.com | Hundreds of people are in jail based on unjust convictions for causing the so-called "shaken baby syndrome."


New scientific work reveals that people convicted of causing the shaken baby syndrome are probably innocent. It turns out that the syndrome, strictly defined, is based on medical inferences recently proven faulty.


If a baby dies suddenly and the cause of death is found to be bleeding inside the skull without other injuries, it's become standard practice for doctors to diagnose these observations as the "shaken baby syndrome" and for police to assume that severe shaking of the baby severely harmed and killed the baby.


Based on this presumption, police usually suspect the last person alone with the baby as having killed the baby. This person is often accused of murder - even when medical and other evidence points elsewhere.


For example, babysitters have been charged with harming infants when subsequent tests show a chronic subdural hematoma that originally developed long before the babysitter even saw the child. Because of the shaken baby presumption, prosecutors often falsely accuse the nearest caregiver even when other conditions (such as a fall several days or even weeks earlier, severe allergic reaction, or brain infection) actually led to the baby's death.


Several doctors created the concept of the shaken baby syndrome in the 1970s. They suspected that shaking a baby too hard, even without the baby's head hitting anything solid, could cause injury and bleeding inside the skull severe enough to induce death. Unfortunately, although this diagnosis was simply a hypothesis without medical proof, it became accepted medical wisdom.


More recently, Michael Prange, Ph.D., Brittany Coats, B.S., Ann-Christine Duhaime M.D. and Susan Margulies, Ph.D., medical researchers at the Children's Hospital of Philadelphia, experimentally tested the shaken baby hypothesis. They published their results last year in the Journal of Neurosurgery.

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In a series of careful experiments using models, they simulated the forces thought to produce the injuries associated with shaken baby syndrome. They discovered that neither a man nor a woman can shake a baby hard enough to only cause tearing or disruption of brain parenchyma (brain tissue, the substance of the brain itself) or bleeding inside a baby's skull, either in the brain itself (cerebral contusion and hematoma) or in the tissues between the brain and the skull (such as a subdural hematoma). The usual definition of shaken baby syndrome excludes injuries to the neck. The researchers' experiments indicated that even the most vigorous shaking alone , without hitting the baby's head against a solid surface, could injure a baby's neck but could not cause bleeding inside the skull.


Dr. Ronald Uscinski, MD, a neurosurgeon practicing in the Washington DC area, reviewed the syndrome in the current issue of the Journal of American Physicians and Surgeons (http://www.jpands.org/vol9no3/uscinski.pdf). In his address to the associations' annual meeting in Portland, Oregon, in mid-October, he observed, "Whenever we pick up an infant, we always support the head. Why? We know intuitively that the infant's neck is too weak to support its own head. Therein lays a truth. If a baby's neck is that weak, that's where we should look for injury from shaking. Yet, by definition, none of these infants supposed to suffer from shaken baby syndrome has such a spinal cord injury. Could shaking harm a baby? Yes, I think so. But the damage would first be to the chest or cervical spine; it would not be an isolated head or brain injury."


Shaken baby syndrome has become enshrined in our courts and hospitals over the last three decades. It's become popular to believe in it, and to prosecute and persecute the presumed perpetrators of this terrible harm.


Babies and infants deserve to be protected from real trauma; parents and caregivers need to be protected from unfounded suspicions. With scientific evidence in hand, let justice and good medical judgment rule - for the sake of the children and for all of us who love and care for them.

Editor's Note: Robert J. Cihak wrote this week's column




Michael Arnold Glueck, M.D., is a multiple award winning writer who comments on medical-legal issues. Robert J. Cihak, M.D., is a Discovery Institute Senior Fellow and a past president of the Association of American Physicians and Surgeons. Both JWR contributors are Harvard trained diagnostic radiologists. Comment by clicking here.

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