Moms who see PURPLE might help reduce shaken baby syndrome

Giving new mothers educational materials about how to deal with crying newborns could help to prevent shaken baby syndrome, a Canadian study suggests.

In Monday's online issue of the Canadian Medical Association Journal, researchers looked at 1,279 mothers in Greater Vancouver. Half of the participants were given an 11-page booklet and DVD developed by the National Center on Shaken Baby Syndrome in Utah.

Shaken baby syndrome, or inflicted traumatic brain injury, is caused by the violent shaking of a child with or without contact between the child's head and a hard surface.

"It's a devastating problem," said Dr. Charles Ferguson, a clinical pediatrician at the Child Protection Centre at the Children's Hospital of Winnipeg.

In the study, mothers who received the prevention materials scored five per cent higher (63.8 points out of 100) in their knowledge about crying compared with mothers who received control materials including a brochure of parent safety tips and a DVD of clips from the Back to Sleep campaign on recommended sleeping positions (58.4 points), the researchers found.

The prevention materials, known as PURPLE, indicated that these behaviours are normal but frustrating for parents:

• P eak patterns, where crying increases, peaks during the second month, then decreases.
• U nexpected timing of prolonged crying.
• R esistance to soothing.
• P ain-like look on the face.
• L ong crying bouts.
• E vening and late afternoon clustering.

To help caregivers to deal with a crying infant, the materials suggest coping mechanisms that include:

• Use calming responses, such as carrying, comforting, walking and talking.
• Put the baby down in a safe place and then walking away to calm yourself.
• Never shake a crying baby.

Ferguson commended the researchers for getting the information out, and suggested his own tip for parents: recruiting grandma to help.

Share the knowledge

The PURPLE recipients walked away 1.7 times more frequently from an inconsolable infant crying. They were also 13 per cent more likely to warn about the dangers of shaking infants and to share advice about walking away if frustrated, the team found.

"This study was not designed, nor was it large enough, to test whether receipt of the PURPLE materials reduced the incidence of shaken baby syndrome," Dr. Roland Barr of the University of British Columbia's pediatrics department and his colleagues concluded.

"However, these results are encouraging that some knowledge and behaviours may be amenable to change when materials are delivered soon after birth during home visits by public health nurses."

The materials aimed to turn mothers into custodians of the knowledge on caring for vulnerable infants.

The gain in information sharing was important because research suggests that after the biological parents, temporary caregivers, especially men, are the most common perpetrators of shaking, the study's authors noted.  

A 2003 study of major pediatric hospitals in Canada estimated shaken baby syndrome happens to 40 babies a year in the country. 

The annual rate of inflicted brain injury is estimated at 30 per 100,000 children aged one year or younger, the researchers said.

Study author Ronald Barr and the National Center on Shaken Baby Syndrome jointly hold the regisistered trademark for the PURPLE materials, and he received a minor share in the profits from the sale of the products.