Does Shaken Baby Syndrome Really Exist?

Does Shaken Baby Syndrome Really Exist?  Source: Discover

…is important to clarify that DISCOVER is weighing the science behind the textbook definition of shaken baby syndrome, not delving into casework involving children who do display “external signs of abuse.” This article is about the evidence for and against a specific syndrome, not the vital importance of child abuse prevention.

The Centers for Disease Control and Prevention reports that as of 2005 there were between 1,200 and 1,600 confirmed SBS cases per year. While no official statistics are available on SBS prosecutions, Toni Blake of the American legal consulting firm 2nd Chair Services says that at least 2,000 to 3,000 lawyers and defendants have contacted her over the past decade to request assistance on SBS trials and appeals around the country. In 2007, she says, “we saw one of these cases overturned about once a month.”

 

As with baby Matthew Eappen in the Woodward case, SBS typically first presents itself when an infant is brought to a hospital or doctor’s office suffering a life-threatening condition such as convulsions, an inability to eat or to be awakened, or difficulty breathing. (SBS can also present with seemingly less serious symptoms, such as changes in feeding behavior.) The 2001 SBS textbook cites two studies (from the journals Annals of Emergency Medicine and Developmental Medicine and Child Neurology) showing that between 15 percent and 33 percent of SBS-symptomatic infants died, while one-third to one-half suffered permanent injury such as paralysis or mental retardation. Although many infants are hospitalized with life-threatening conditions, it is only on closer examination—CT or MRI scans of the infant’s head and ophthalmological examination of the infant’s eyes—that a diagnosis of shaken baby syndrome comes into play.

“The thing we pick up on most easily is the bleeding,” says Randell Alexander, chief of the division of child protection and foren­sic pediatrics at the University of Florida at Jacksonville College of Medicine. “You see intracranial bleeding, between the brain and the skull…and then the other thing you see in about 90 percent of the cases is retinal hemorrhages.”

Once a doctor says that an infant must have been shaken, it triggers a hunt for the shaker. In one diagnostic step, the legal system is brought to bear on the baby’s family and anyone else near the infant at the time of the supposed shaking.

The symptomatic triad of bleeding between the brain and skull (known as subdural or subarachnoid hematomas), bleeding behind the retinas, and brain swelling is both the core of an SBS diagnosis and the point of departure for the syndrome’s skeptics. The medical proof that shaking alone can cause these internal head injuries is questionable, the skeptics say, when many other things, from infections to malnutrition to falls onto a hard surface, are known to be causes of similar symptoms in infants.

One such skeptic testified for the prosecution in the Woodward case but later changed his stance. Pediatric neuroradiologist Patrick Barnes of Stanford University said in an e-mail interview, “It is known from case records that SBS is misdiagnosed/overdiagnosed. It is not only a problem in medicine but a problem in the justice system.”

 

…Uscinski traced medical citations in SBS research back to a 1968 study involving rhesus monkeys subjected to collisions and violent accelerations. Uscinski already knew the study—it had been conducted by his mentor, Ayub Ommaya, the very same colleague who had brought him into the Woodward case. Uscinski says the study yields no firm conclusions about the consequences of shaking monkeys or, for that matter, babies.

Despite his confidence in the existence of SBS, Newberger adds that he has consulted for the defense on two or three SBS cases in which, he says, a “juggernaut” develops. “The department of social services sends out a social worker,” he says, describing the usual procedure after a doctor reports a possible SBS case to the authorities. “If a parent does not know exactly what’s happening, very frequently the first conclusion is that they’re trying to hide something. And sometimes parents are racking their brains, coming up with one or two possibilities. Then it looks like they’re changing their stories. That can be used to damn them.”

The Haynes family of Rantoul, Illinois were caught in just such a juggernaut. In October 2005 the father, Neal, was charged in a civil case with shaking his then 3-month-old son, Jake (not his real name). Although not accused of shaking the baby, the mother, Christy, was also charged with abuse and neglect (for permitting the alleged shaking). Jake had been hospitalized three times over two months for fever, infection, difficulty breathing, and symptoms of seizures. He survived his third hospitalization and returned home healthy, with his parents. However, when emergency room doctors discovered retinal and subdural hemorrhages, they concluded that Jake’s medical problems must have stemmed from his being violently shaken.

 

In the Haynes case, Uscinski rendered a professional opinion that concluded, “There is no question but that [Jake] Haynes had a chronic subdural hematoma.” As a chronic (rather than acute) case, by definition the “hematoma had its genesis weeks or months earlier.” Uscinski suggested that baby Jake’s breech birth could have itself produced enough force on the brain to cause subdural bleeding. This kind of wound sometimes doesn’t heal and can go undetected for weeks or months, he says.

F. Edward Yazbak, a Massachusetts-based pediatrician, examined Jake’s medical records and wrote a 51-page report for the defense that pointed to other possible causes of baby Jake’s hemorrhages, including adverse reaction to his vaccinations, a vitamin C and K deficiency, and/or a toxic level of histamine in his blood.

By late December, following the ongoing case, the defense’s Yazbak learned about Jake’s enlarging head size—brought about, he concluded, by a subdural hematoma that was in fact bleeding again. “[Yazbak] said this child has got to see a specialist immediately,” Fischer says. “If it’s unchecked, he’ll die.” The lawyers called a meeting with state child protective services, petitioning for a second opinion on Jake’s condition. Ultimately he was sent to a hospital in St. Louis, where doctors operated on the hematoma and put in a shunt.

The doctors “had gotten into the routine that it was shaken baby syndrome,” Fischer says. “And they could not get out of that routine.”

“For the jury…the defense needs to prove what happened to this baby,” she says. “Unless you’ve got the money to hire top experts, you’re probably going to prison….It’s guilty until proved innocent.”

Cheri Landers, chief of the division of pediatric critical care at Kentucky Children’s Hospital in Lexington, says that if an infant were brought into the emergency room suffering seizures and was discovered to have a subdural hematoma and retinal hemorrhaging, she would want to ask the family about the background before rendering a diagnosis. “We would need to find out…was there any known trauma?” she says. According to Landers, a severe car accident, for instance, could explain subdural and retinal hemorrhages and consequent seizures. She points to a 1993 article in the journal Neurosurgery that examined the retinas of 140 children involved in car accidents. Two had hemorrhages, and both were in high-velocity side-impact crashes.

“When we discover no reason for the trauma,” she adds, “that is the point where we come to the conclusion that there is no reason for this other than shaking.” Landers cites a 2000 study in the journal Pediatrics that evaluated 19 Florida infants with subdural hemorrhages who were referred to the state’s child protective services in 1997. The authors selected nine of these cases and followed them up, reporting that every child was the victim of “inflicted injury, inappropriate infant handling, and/or high-risk social settings” such as a family with a history of domestic violence.

Neuropathologist Jan Leestma of Children’s Memorial Hospital in Chicago, who testified for the defense in the Woodward case, has come to a different conclusion. Leestma reviewed 324 apparent or alleged child abuse cases from 1969 to 2001 and published his results in a 2005 issue of the American Journal of Forensic Medicine and Pathology. Fifty-four of these cases involved shaking a baby. He found only 20 percent (11 cases) yielded no evidence of any impact to the baby’s skull—such as a fall from a changing table.

Thibault points to a 2003 study in the Journal of Neuro­surgery that used lifelike infant dolls with crash test dummy accelerometers inside their heads. A team of four bioengineers and neurologists from the Children’s Hospital of Philadelphia then simulated vigorous infant shakings—as might happen in an SBS case—as well as shakes that ended in an impact and drops from one-, three-, and five-foot heights.

The group concluded that shaking their model infants produced results “statistically similar” to one-foot falls onto concrete or a carpet pad or higher falls onto a foam mattress. These results were well below reported thresholds for causing the kind of intracranial bleeding observed in SBS babies, suggesting that shaking wasn’t enough to induce SBS.

“It’s drilled into people’s heads that shaking will kill these kids,” Kirk Thibault says. “I don’t know that shaking can’t kill a child. I assume you can probably shake a child to death. I have no idea…. What I specifically look at is whether shaking can cause loads [on the brain] that…can cause subdural hematomas. The flip side of that is people abuse kids,” Thibault says. But he adds, “You can’t simply categorically say this is all nonaccidental. I say one case at a time.”

Neurosurgeon Jean-Sébastien Raul, an assistant professor at the Institute of Legal Medicine at the University of Strasbourg in France, says he has a computer model of infant shaking that could help clarify the controversy. In a 2006 paper published in the International Journal of Legal Medicine, Raul concluded that, biophysically, shaking alone can produce the kinds of subdural hematomas that are seen in SBS cases.

Raul’s group drew from published properties of human baby brains and skulls and pig brains and skulls—markedly similar, he says, in biophysical properties. The group ran computer simulations that examined the behavior of veins that bridge the brain and the covering tissue surrounding the brain. Rupture of “bridging veins,” he says, is a known and well-understood cause of subdural hematomas.

Raul says he knows the 2003 Journal of Neurosurgery paper well but argues that the authors looked only at acceleration inside the skull. “We are looking at the relative motion between the brain and skull,” he says. It is this additional factor, he thinks, that produces the bleeding inside the shaken infant’s skull.

Thibault points out that Raul’s group conducted computerized experiments involving unknown situations without first confirming that their model could reproduce known experimental results. For instance, in 1984 Nobuhiko Aoki and colleagues at Nagoya University in Japan studied medical case records of infants who had fallen and hit their heads. Some had died, some had survived. All, Aoki said, had subdural hematomas and retinal hemorrhages and thus could potentially be seen as SBS cases. “You first have to [run your computer model] outside of the vacuum of your model,” Thibault says. “At least demonstrate that you can draw a line and say this is a threshold…and now I’m going to re-create every single one of Aoki’s falls.”

In July 2001 Coffee’s client was taking care of his 11-month-old son, Mike (not his real name), whom pediatrician Yazbak later described as suffering from “multiple medical problems” including malnutrition and possible blood coagulation deficiency. On July 10 Mike stopped breathing. According to Coffee, his client attempted CPR and called 911 before taking the child to a Las Vegas emergency room. Mike ultimately died on life support. Bruises were found on his abdomen and back, and paramedics had found a cut under his eyelid. Postmortem examinations revealed a subdural hematoma and retinal hemorrhaging.

With an existing criminal record that he feared would bias the trial, Coffee’s client opted to plead to shaking baby Mike. “I’m sure at some point during the failed attempt to resuscitate Mike, he was shaken, and as the local doctors were willing to testify that shaking caused the death, there wasn’t a problem getting the plea down,” Coffee said in an e-mail. In October 2007 Coffee’s client was sentenced to 10 years to life for second-degree murder.

Around the same time, the Wisconsin Law Review published a paper entitled “Shaken Baby Syndrome: Medical Uncertainty Casts Doubt on Convictions.” The paper’s author, Molly Gena, now a Milwaukee-based lawyer for Legal Action of Wisconsin, says her review of recent SBS decisions indicates the tide is beginning to turn.

“It started with the British cases,” Gena says, referring to a review ordered by the British attorney general, Lord Goldsmith, of 297 alleged child abuse cases, some of which were SBS convictions based only on the triad of internal symptoms: subdural hematoma, retinal hemorrhage, and brain swelling. In one case, R v. Harris, the court concluded that “the mere presence of the triad on its own cannot automatically or necessarily lead to a diagnosis of [SBS].”…

 

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SBS and the Vaccine Connection Resources/Articles

Is it Shaken Baby or Barlow’s Disease Variant?

 

C. Alan B. Clemetson, M.D.

ABSTRACT-Retinal petechiae, subdural hemorrhages, and even broken bones do not always indicate trauma or child abuse. Infantile scurvy or a variant form still occurs today and can be mistakenly diagnosed as nonaccidental injury (NAI). Histamine levels, which are characteristically increased in vitamin C depletion, may reach a toxic level owing to infection or the injection of foreign proteins. Histamine intoxication can cause a variant of Barlow.s disease, with weakness of the retinal vessels and the bridging veins and venules between the brain and the dura mater in infants.

 

Elevated blood histamine caused by vaccinations and Vitamin C deficiency may mimic the shaken baby syndrome 

The findings of subdural hematoma and retinal hemorrhages in infants, without any documented history of major trauma, do not always indicate child abuse. A combination of ascorbate depletion and the injection of foreign proteins can cause a very high blood histamine level, leading to capillary fragility and venular bleeding. This can be prevented by the administration of vitamin C. PMID: 15050101 [PubMed – indexed for MEDLINE]

WAS THAT BABY REALLY SHAKEN?

C. Alan B. Clemetson, M.D. Well-meant child-abuse laws have given rise to many inappropriate accusations of shaken-baby-syndrome, without any real evidence that the infants were ever shaken or assaulted in any way.

 

SBS or Vaccine-Induced Encephalitis?

Harold E. Buttram, M.D. The shaken baby syndrome theory, as it stands today, assumes that findings of brain and/or retinal hemorrhages in the absence of known major accidental trauma are diagnostic of shaken baby syndrome (SBS), sometimes also referred to as non-accidental injury. For reasons that will be reviewed in this article, this theory is being increasingly challenged in the scientific literature.

 

Shaken Baby Syndrome on Shaky Ground

Viera Scheibner, PhD. Published in the “Journal of Australasian College of Nutritional & Environmental Medicine”, Vol. 20 No. 2; August 2001.  ABSTRACT -An epidemic of accusations against parents and baby sitters of Shaken Baby Syndrome is sweeping the developed world. The United States and the United Kingdom are in the forefront of such questionable practice. Brain (mainly subdural, less often subarachnoid) and retinal haemorrhages, retinal detachments, and rib and other bone ‘fractures’ are considered pathognomic. However, the reality of these injuries is very different and well documented: the vast majority occur after the administration of childhood vaccines and a minority of cases are due to documented birth injuries and pre-eclamptic and eclamptic states of the mothers.

 

RULES OF EVIDENCE IN THE COURTS

Harold E. Buttram, MD. Court rules of evidence affect SBS defenses. Among the many adversities and difficulties facing the American family today, there is a relatively new and growing hazard — one featuring a parent or caretaker who may be falsely accused of murdering or injuring an infant by shaken baby syndrome, when the true cause of death or injury arises from other sources. Very tragically, child abuse does occur and deserves appropriate punishment. However, it is equally tragic when a family, already grieving from the sudden and unexpected death of their infant, finds a father or mother unjustly accused, convicted, and imprisoned for murder of the infant, a murder of which he or she is innocent. I know of an attorney, an anesthesiologist, a Mormon mother, an Amish mother, and others accused and/or imprisoned (many believe falsely) on charges of injuring or murdering an infant by SBS. It could happen to anyone regardless of race, sex, education, finances, or social status.

 

SBS Defense

 

 

Shaken Baby Syndrome: Pitfalls in Diagnosis and Demographics

F. Edward Yazbak, M.D., FAAP. Medical Studies.

 

Multiple Vaccinations And the Shaken Baby Syndrome 

Child abuse is a terrible crime and the failure to recognize it is unforgivable. An erroneous diagnosis of inflicted head trauma is just as tragic and the resulting destruction of a family is one of the gravest injustices of modern times. Many have recently questioned the existence of the so-called “Shaken Baby Syndrome” and the concept that the last caretaker must have been guilty. Careful reviews often uncover relevant findings that were missed or ignored. Recent pediatric vaccinations have been suspected as precipitating factors. A recent combination of seven antigens is the focus of this investigation. The three vaccines in question were 5 in 1 vaccine combination, HIB conjugate vaccine, 7-valent pediatric pneumococcal vaccine.

 

SUDDEN, UNEXPLAINED INFANT DEATH INVESTIGATION

CDC. I the world of death investigation, infant death investigation is unique. From scene through certification, these investigations require skill and knowledge drawn from disciplines outside those typically considered a part of medicolegal education. This chapter presents an overview of sudden, unexplained infant death, its typical causes, and the importance of the death scene investigation to accurate cause and manner of death determination.

 

Shaken Baby Syndrome and the Death of Matthew Eappen

A Forensic Pathologist’s Response

John Plunkett, M.D.  The American Journal of Forensic Medicine and Pathology 20(1):17-21, 1999.

Subdural hemorrhage, retinal hemorrhage, and cerebral edema have been considered diagnostic for a “shaken infant” since the syndrome was described almost 30 years ago. However, the specificity of these findings has been disputed by defense witnesses in recent U.S. criminal prosecutions. This review examines the scientific basis for the shaken baby syndrome.

 

 

Shaken Babies

Articles by Archie Kalokerinos, MD

 

Sudden Infant Death and the Shaken Baby Syndrome: How They Are Connected!

 

Lecture Was Given by Archie Kalokerinos, MD  

Dr. Kalokerinos believes that the pathologies found at autopsy on many of these “shaken” babies, which include intracranial and retinal hemorrhages and bone changes that can be mistaken for fractures, are due to processes involving infections and toxins produced by the infections, along with an increased utilization of vitamin C.  Dr. Kalokerinos has reasons to believe that there is a relationship between SIDS (sudden infant death syndrome) and the pathologies found in SBS (shaken baby syndrome.)

 

 

The evidence base for shaken baby syndrome

BMJ 2004 328:719-720 Editorial

The phrase “shaken baby syndrome” evokes a powerful image of abuse, in which a carer shakes a child sufficiently hard to produce whiplash forces that result in subdural and retinal bleeding. The theory of shaken baby syndrome rests on core assumptions: shaking is always intentional and violent; the injury an infant receives from shaking is invariably severe; and subdural and retinal bleeding is the result of criminal abuse, unless proved otherwise.1 These beliefs are reinforced by an interpretation of the literature by medical experts, which may on occasion be instrumental in a career being convicted or children being removed from their parents. But what is the evidence for the theory of shaken baby syndrome?

 

 VITAMIN C and SBS

 

Child Abuse or Life-Threatening Medical Misdiagnosis?

No reliably-witnessed case of shaking in America has ever produced the symptoms associated with SBS, so accusations are based on assumptions, which in turn are based on symptoms alone–symptoms that singly and as a group have medical causes unrelated to abuse. The fact is, there are tests that can separate the innocent from the guilty, but doctors refuse to run them (DIFFERENTIAL DIAGNOSIS–eliminating medical causes to support an assumption of abuse).This only happens in suspected SBS cases in spite of pediatric emergency medical guidelines compelling doctors to do so. The question is, “Why?”

 

Shaken Baby/Impact Syndrome: Flawed Concepts and Misdiagnoses

(Based on a Review of Twenty-Two Cases) Harold E Buttram, M.D.

The following article represents a review of twenty-two cases of shaken baby syndrome (SBS) accusations and/or convictions over a period of approximately three and a half years. Its primary purpose is to offer a composite of information gained from study of these cases to parents or caretakers who have been accused and/or convicted of child abuse in the form of SBS, information which may be of value in their defense. Every effort has been made to maintain simplicity and clarity in the organization of the material. Each section is designed to be complete in itself, and for this reason some portions are repetitious. 

 

In the News:

 

Review of infant deaths urged

 

New look at 142 `shaken baby’ cases over 2 decades justified, Ontario chief forensic pathologist says.

 

MD casts doubt on shaken baby syndrome

 

The deaths of 142 Ontario babies since 1986 were attributed to a cause many scientists now believe has been discredited – shaken baby syndrome – the province’s top forensic pathologist testified yesterday.

At the time, the fact that most of the injuries were to her neck, shoulders and head was considered highly unusual and suggestive of a homicidal stabbing. However, Dr. Pollanen said that recent studies have shown that, unlike attacks on adults, dogs frequently savage those portions of a child’s anatomy.

 

Michael Pollanen told Mr. Justice Stephen Goudge that skepticism about SBS is so great that he should consider urging a review of the cases when he produces his report next spring.

Dr. Pollanen said he did not know how many of the 142 cases were investigated as suspicious deaths, resulting in criminal charges, convictions or the seizure of siblings from the parents of the pediatric victims.

“To be very straightforward, this would generate a lot of controversy in the community… because it is very polarized,” Dr. Pollanen said.

The inquiry was launched last spring to look at how the province’s former star pathologist, Charles Smith, was able to rise to the top of his profession despite a series of autopsy errors that led to miscarriages of justice.

However, Dr. Pollanen’s revelation yesterday went beyond Dr. Smith to include the work of other pathologists who diagnosed SBS – a conclusion that was typically made upon the discovery of brain swelling and retinal bleeding combined with tissue damage to the linings of the brain.

Dr. Pollanen said that in recent years, a significant segment of the scientific community has come to believe that these symptoms can be found in babies who suffer an accidental blow to the head or an innocent fall.

He testified that Britain took the lead a couple of years ago, systematically re-examining a large number of SBS cases in what became known as the Goldsmith review.

“In the U.K., some of these convictions were quashed,” he said. “The scope of the problem is not clear in Ontario. There needs to be some consideration of whether we should undertake something like the Goldsmith review.”

Similar reviews may follow in other countries, Dr. Pollanen said.

“One of the factors to put fuel on the fire in the U.S. is that traditionally, sentences have been robust in these kind of cases – the death penalty or life imprisonment.

“In the face of what some people believe to be remarkable miscarriages of justice in some of these cases, it really has polarized groups of experts.”

Dr. Pollanen also testified that:

A 1991 ruling by a judge of the Ontario Court of Justice who acquitted a 12-year-old of murdering a baby was “a masterful analysis of the case … that was slightly ahead of its time.” Dr. Pollanen was effectively endorsing the judge, Mr. Justice Patrick Dunn, who rejected Dr. Smith’s testimony in acquitting the babysitter. The inquiry has heard that Dr. Smith often told colleagues that Judge Dunn later confided he regretted the acquittal and should instead have convicted the babysitter.

With not a single medical school in Canada offering forensic pathology training as an area of subspecialty, “I would say we have lagged about 40 years behind in comparison to other systems.”

Forensic pathologists working in provincial coroners’ systems are “prohibitively” underpaid in comparison to their counterparts in the private sector.

Defence counsel in Ontario will never have more than one or two forensic pathologists willing to work on homicides unless legal aid funding improves substantially and experts get over their revulsion for disputing conclusions by colleagues testifying for the Crown.

Advances in forensic pathology have made it even more clear that a Kingston baby known as Sharon definitely died of bites from a pit bull.

 

Controversial doctor admitted his knowledge of forensic pathology was ‘woefully inadequate’

Tom Blackwell / National Post-Canwest News Service   January 28, 2008

TORONTO – Dr. Charles Smith apologized for his mistakes again Monday and admitted his knowledge of forensic pathology was “woefully” inadequate during his years as head of Ontario’s pediatric forensic pathology unit.

Smith began his much-anticipated testimony at the inquiry examining his discredited work by acknowledging and voicing regret for his well-documented failings.

As several of the people wrongly prosecuted for homicide in his cases looked on, he conceded he had little training in the forensic field or in courtroom testimony and sometimes behaved unprofessionally.

“I have come to appreciate mistakes I have made and I am sorry for them,” a solemn-looking Smith told the inquiry. “I also recognize that at times my conduct was not professional and I deeply regret that.

“I do accept full responsibility for my work and for my opinions and for my actions.”

The inquiry was called last year after a panel of international experts found he had made serious errors in 20 of 45 criminally suspicious deaths he helped investigate between 1991 and 2001. Parents or other caregivers were charged in most of the cases, though many have since been cleared.

The outside experts told the inquiry Smith came to conclusions that were clearly unjustified, gave speculative and misleading testimony and seemed to have no training in forensic pathology.

Top officials of the coroner’s office said they generally overlooked the mistakes for more than a decade.

Colleagues testified to Smith’s disorganized, tardy work habits.

Though he was certified as a pediatric pathologist, he conceded Monday he received virtually no formal training in forensic pathology – dealing with cases that have a legal aspect.

“It was self taught, it was minimal,” he said of his knowledge of the field. “In retrospect, I realize it was woefully inadequate.”

He also confessed to receiving little training in being an expert witness at criminal trials, apart from a two-day course he took in the United States.

“I thought I knew it, but I realize now just how profoundly ignorant I was.”

Sherry Sherret, convicted of infanticide in the 1996 in the death of her four-month-old son Joshua, said she has many questions she wants to hear answered by the pathologist, whose evidence was key in her case.

“I would want to ask him . . . why did he do it, how does he feel, does he regret anything that he did,” she said, but conceded that others bear some of the blame for what happened, too.

“In the long run, it’s not 100 per cent his fault, because obviously, someone wasn’t watching him.”

 

Doubts about shaken baby syndrome

…is the science related to it conclusive enough to convict beyond reasonable doubt when there is little other evidence pointing to guilt?

 

Shot in the dark

Heartbroken woman wonders if vaccines killed her infant son


Shaken Baby Syndrome: Debunking the Myth

In 1997 the world held its breath as the media followed closely Louise Woodward’s “nanny” trial. She had allegedly committed the crime of shaking a baby, which resulted in the death of infant Matthew Eappen. Miss Woodward was a 19-year-old British au pair with no criminal record, yet she was “disliked” by the camera and as is often the case in crimes involving children, was presumed guilty. 

Doubt over ‘shaken baby’ theory that has sent dozens of parents to prison

Two British pathologists have found that a combination of injuries used to diagnose abuse, known as the “triad”, can happen naturally.

Dr Irene Scheimberg, from London’s Bart’s Hospital, and Dr Marta Cohen, from Sheffield Children’s Hospital, warn that bleeding on the brain and retinas, swelling of the brain and oxygen deficiency do not only occur through vigorous shaking.

Their discoveries could have a dramatic effect on future child abuse trials and child protection hearings.

Dr Scheimberg said: “When there is no evidence of physical abuse, apart from the haemorrhaging, we may be sending to jail parents who lost their children through no fault of their own.

“As scientists it is our duty to be cautious when we see the triad and to take each case on its merits. We owe it to children and their families.”

The study, published in the journal of Paediatric Developmental Pathology, found that the symptoms of shaken baby syndrome can happen in babies before they are taken home from hospital.

The authors looked at 25 babies who had died shortly before delivery and 30 newborns who had haemorrhages and found similar damage to the brains of all the babies.

The study concluded that the symptoms are common in young babies and could be caused by a traumatic birth or other conditions.

Dr Scheimberg and Dr Cohen believe that what they have found means police and lawyers will need more evidence than bleeding in the brain to prove that a baby has suffered child abuse.

Dr Scheimberg said: “We now know that mothers who have babies through normal vaginal delivery can have a child with a subdural haemorrhage and also retinal bleeding.

“We also know that many of these bleeds resolve themselves – with no outward sign of damage in the first few weeks of life and these children grow up to live a normal life.

“The other group are those children who present with signs of shaken baby syndrome whose bleeding has continued and got worse. These are the children who the courts suspect have been harmed by their parents.”

The evidence could now be used in a string of appeals, including the case of childminder Keran Henderson, who is serving three years for the manslaughter of 11-month-old Maeve Sheppard.

Medical experts argued that Maeve’s injuries indicated that she had been violently shaken.

But Henderson, of Iver Heath, Buckinghamshire, said the baby had a fit while she was changing her nappy.

Her lawyer, leading child abuse expert Bill Bache, said he was “absolutely sure” the research will be used in appeal cases.

“It is very likely we will use it in Keran Henderson’s appeal,” he added.

Mr Bache said the evidence may also be used in at least four further cases.

The “triad” of symptoms first came to public attention in 1998 in the US trial of British au pair Louise Woodward, who was found guilty of the second-degree murder of eight-month-old Matthew Eappen in October 1997. She was sentenced to a minimum of 15 years to life in prison.

Her conviction was then reduced to involuntary manslaughter. Her sentence was also reduced to time served on remand, 279 days, and she was freed.

Around 200 cases of shaken baby syndrome are diagnosed in Britain every year and many accused of abuse strenuously deny any wrongdoing.

 

Shaken Baby Syndrome Debate-Article

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Shaken Baby Syndrome Article

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