Shaken baby study warning for parents

By STAFF REPORTER and AGENCIES

Babies can die from brain injuries caused by even gentle shaking, one of the largest and most detailed studies yet has found.

Doctors in Britain found that "rough handling" could be enough to damage nerve fibres in the neck that control breathing, leading to the brain swelling also characteristic of violent shaking.

The research has far-reaching legal implications since convicting people of shaking a baby to death may become more difficult.

The research, published in New Scientist and soon to be published in the specialist neurology journal Brain, challenges the view that only extreme violence causes "shaken-baby syndrome."

Lawyers say the findings would have seriously weakened the 1997 case against British nanny Louise Woodward, who was convicted in America of manslaughter after the death of a baby in her care.

She maintained that she was innocent, but American prosecutors said she must have shaken eight-month-old Matthew Eappen with all her might for up to a minute to kill him.

The study, led by Jennian Geddes, a neuropathologist at the Royal London Hospital, examined the brains of 53 children - 37 of them under a year old - who died of suspected deliberate head injuries.

They were looking for a symptom known as "diffuse axonal injury" (DAI), thought to occur when severe force - such as occurs in hard shaking - is applied to the brain.



They found very few suffered DAI.

Three-quarters of the brains showed signs of damage due to stretching where the brain joins the spinal cord - the sort of injury that could occur if a baby's head was allowed to flop backwards and forwards hard.

The spot is especially vulnerable in young babies because their neck muscles are very weak and their heads are quite large.

Dr Geddes said nerve fibres in the baby's neck that control breathing could be damaged by unsupported movements of the child's head and could lead to a lack of oxygen. That would cause the brain to swell, and eventually the baby would die.

She believed the two-year study had found a type of damage not previously reported.

"Contrary to what is widely thought, violent shaking may not be necessary to cause a fatal injury in a baby."

But Dr Geddes and her co-researcher, Professor Helen Whitwell, head of forensic pathology at Sheffield University, said normal play between an adult and a child, such as bouncing a baby on the knee, would not lead to serious injuries.

"It would have to involve vigorous unsupported movement of the head," said Dr Geddes.

But it would be possible to produce the damage without it being deliberately inflicted.



In such cases, an onlooker would probably think the baby was being mishandled, but not necessarily violently assaulted.

New Scientist and British legal experts claim the research could lead to legal challenges in abuse cases, as prosecutors would need much stronger evidence of intentional shaking to get a conviction.

John Binns, a top London criminal lawyer, said the findings could affect the way courts treated shaken-baby cases.

"Unless it is certain that injuries were caused by gross negligence or worse, the judge will direct the jury to acquit.

"On the basis of these findings, it is impossible to imagine a prosecution succeeding in anything but the clearest cases."

Gael Brooks, of the Child Safety Foundation of New Zealand, said the study sounded feasible.

Parents had been told for generations that they should support babies to stop their heads rolling violently.