Pediatricians adopt new term for shaken baby abuse

The nation's largest pediatricians' group recommends "abusive head trauma," calling it a more comprehensive diagnosis for brain, skull and spinal injuries associated with shaking and other head injuries inflicted on infants.

The academy says the new diagnostic term should be used in medical records and that it may provide more clarity in the courtroom.

Some defense attorneys and doctors believe shaken baby syndrome doesn't exist, arguing that it's impossible to shake babies hard enough to cause brain injuries without breaking their necks. But that argument is based on faulty evidence and is not shared by most physicians who specialize in treating child abuse, said Dr. Robert Block, former chairman of an academy committee on child abuse.

The National Institutes of Health says shaking can cause bruising, swelling, and bleeding, "which can lead to permanent, severe brain damage or death."

Block said legal challenges to the term "shaken baby syndrome" can detract from more important questions about whether abuse occurred. The new term can avoid that problem, he said.

"In no way does this change the position of the academy" about the potentially fatal risks of shaking an infant, said Block, a pediatrics professor at the University of Oklahoma's community medicine school in Tulsa.

The pediatrics academy recommends the new terminology in a policy statement being published in the May issue of its journal, Pediatrics.

Dr. Cindy Christian, a co-author of the policy statement and a child abuse researcher at Children's Hospital of Philadelphia, said evidence shows babies can be injured by severe shaking alone but sometimes they have head injuries caused by other abuse as well.

The National Center on Shaken Baby Syndrome says an estimated 1,200 to 1,400 U.S. children are injured or killed by shaking each year, but that the number may be much higher since many cases likely are not detected.

The advocacy group also uses the umbrella term "abusive head trauma," but says shaking is the leading cause of death in these cases.

The pediatricians' new policy says doctors should be alert to signs of head trauma that could include abusive shaking. Doctors also should teach parents safe ways to calm fussy babies and how to avoid the dangers of shaking, the policy advises.

Marilyn Barr, executive director of the center on shaken baby syndrome, praised the academy for "trying to clear murky waters."

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On the Net:

Academy of Pediatrics: http://www.aap.org/

NIH: http://tinyurl.com/38d8vd

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