Program Effective In Educating Parents About Prevention Of Shaken Baby Syndrome

Each year in the United States, an estimated 1,300 infants are hospitalized or die from shaken baby syndrome. One in four babies will die as a result of their injuries, and among those who survive, approximately 80 percent will suffer brain injury, blindness and deafness, fractures, paralysis, cognitive and learning disabilities, or cerebral palsy.

"Typically, crying begins within two weeks of birth so it's imperative that new parents receive information and learn coping strategies early," says Fred Rivara, MD, MPH and co-author of the Seattle study. Dr. Rivara is an investigator at the Harborview Injury Prevention and Research Center, and vice-chair of pediatrics at the University of Washington.

Both studies were randomized controlled trials testing of "The Period of PURPLE Crying," an educational program that includes a 12-minute DVD and information booklet. In Seattle, Dr. Rivara was joined by Dr. Ronald Barr, lead author of both studies and director of community child health at the Child & Family Research Institute and professor of pediatrics in the Faculty of Medicine at the University of British Columbia.

The Seattle study involved 2,738 mothers of new infants. Half the women enrolled in the study received the PURPLE materials while half received information on infant safety. Mothers who received the PURPLE materials scored six percent higher in knowledge about crying and one percent higher in knowledge about shaking. They were six percent more likely to share information with caregivers about strategies for coping with the frustration of infant crying, and seven percent more likely to warn caregivers of the dangers of shaking.

Like their American counterparts, Vancouver mothers who received the PURPLE materials scored 6 percent higher in knowledge about crying, were 13 percent more likely to share information with caregivers about coping with inconsolable crying, 12.9 percent more likely to share information about the dangers of shaking, and 7.6 percent more likely to share information about crying.

"Changing knowledge is a critical first step in changing behavior, and this is important public health work because the results show it's possible to change people's ideas about crying." said Dr. Barr. PURPLE materials are designed to teach parents that crying is normal and frustrating for caregivers, and they list the following features as typical:

• Peak pattern, when crying increases, peaks in second month, then declines
• Unexpected timing of prolonged crying
• Resistance to soothing
• Pain-like look on the face
• Long crying bouts
• Evening and late afternoon clustering

In 2008, The Centers for Disease Control and Prevention, the Doris Duke Charitable Foundation, and the Duke Endowment funded the first trial implementation and evaluation of "The Period of PURPLE Crying Program" in North Carolina.

Joining Dr. Barr and Dr. Rivara on the Seattle study were University of Washington researchers James Taylor, M.D., MPH, professor of pediatrics; Liliana Lengua, PhD, associate professor of psychology; and Peter Cummings, M.D., MPH, professor of epidemiology. Funding was provided by the Doris Duke Charitable Foundation and the George S. and Dolores Dore Eccles Foundation. Dr. Barr collaborated with Marilyn Barr, executive director of the National Center on Shaken Baby Syndrome on the Vancouver study.

The Harborview Injury Prevention and Research Center is one of the nation's leading institutions dedicated to injury research, and is affiliated with Harborview Medical Center and the University of Washington.

The National Center on Shaken Baby Syndrome develops and tests prevention programs for organizations in North America and provides international training on shaken baby syndrome. The Center developed the PURPLE materials which can be ordered by institutions on their website at http://www.dontshake.org for the cost of US $2 per family.