Friday, October 30, 2009

'One horrible second': Campaign expands to prevent Shaken Baby Syndrome (Salt Lake City, Utah)

Sadly, this baby girl--like the majority of shaken baby victims--was injured by her father. Dad JAY McKIMMY was the dad in this case.

Note the politically correct way of half acknowledging that dads are doing the abusing: "Parents" (read: moms) are relying on "caregivers" they may not have relied on before, such as an "unemployed spouse" (read: dad). And note that all the examples of baby shakers--all dads.

I cannot tell you how many cases I have found of unemployed/under-employed "caregiving" dads who have severely abused or even killed a young child in their care while mom was working. These are guys who are just not cut out for child care--they don't have the patience, or anger control. These are guys who need to be out fixing cars, planting trees, manufacturing stuff--anything that uses their energy instead of expecting them to be like moms or grandmothers. Check out the shaken baby tab below for more cases and the research.

http://www.sltrib.com/news/ci_13679294

'One horrible second': Campaign expands to prevent Shaken Baby Syndrome
By Lisa Rosetta

The Salt Lake Tribune

Updated: 10/30/2009 04:47:38 PM MDT

It was 2 a.m. on a Tuesday when Care Burpee first saw her 9-week-old daughter comatose on a full-size hospital bed, her tiny head wrapped in a turban of white gauze. Tubes strewn everywhere pumped 13 life-saving drugs into her veins.

Burpee was confused. Her husband and older son were snoozing peacefully, unharmed, on the floor of an intensive care unit waiting room at Wilford Hall Medical Center in San Antonio. Yet here was her baby Winter, barely clinging to life.

A doctor walked in.

"We believe your daughter has been shaken," he said. "Does this come as a surprise to you?"

An Air Force linguist, Burpee had left her home in San Antonio Sunday night for a week of training in San Angelo, 200 miles away.

She left Winter and her son, Aspen, with their father and Burpee's now ex-husband, Jay McKimmy.

Frustrated with Winter, who had erupted into fits of crying, McKimmy shook the prematurely born infant and caused head trauma so severe doctors would later describe her brain as "scrambled eggs."

There was no coming back from this, they told Burpee. Winter would be lucky to make it through the next 72 hours. If she did, she might live another month -- maybe a year.

A cultural change » Crying is the No. 1 trigger for child abuse.

Faced with an infant's inconsolable wailing, a tired, frustrated parent or caregiver can "lose it for one horrible second of their life," said Marilyn Barr, founder and executive director of the National Center on Shaken Baby Syndrome in Ogden.

But what many caregivers don't know: All babies go through a normal developmental phase that is characterized by bouts of crying. If comforting an infant doesn't work -- and sometimes it won't -- an irritated parent's best strategy may be to put their screaming baby safely in a crib and walk away.

The "Period of PURPLE Crying," the center's expanding public education effort, hopes to drive a cultural change as profound as the "Back to Sleep" campaign. Since its launch in 1994, the rate of sudden infant death syndrome, or SIDS, has declined by more than 50 percent.

Persistent crying begins around two weeks after a baby's birth, peaks in the second month and ends two or three months later, said Ronald Barr, a pediatrician at BC Children's Hospital in Vancouver, Canada, who is an expert on crying.

This "distress curve," as he calls it, coincides with at least eight other behavioral and physical changes. Infants' attention to things they see, for instance, increases then decreases in a similar pattern. So does the rate at which their bodies burn calories.

The same curve is seen in infants around the world and even other breast-feeding species, including pigs, rats and chimpanzees, said Ronald Barr, who is also director of Developmental Neurosciences and Child Health at the Child and Family Research Institute at the hospital.

Barr hopes wide awareness that crying is "just part of how babies are hard-wired" will lessen caregivers' frustration -- and their likelihood of shaking an infant, which has devastating consequences.

Babies have weak neck muscles and large, heavy heads. The whiplash of violent shaking can bounce their fragile brains inside their skulls, causing bruising, swelling and bleeding. Their eyes can also be jostled, causing retinal stretching and tearing, which can lead to blindness.

An estimated 1,200 to 1,400 babies are shaken in the U.S. each year. About a third of them don't survive, Barr said, and of those who do, 80 percent have permanent brain damage. Since 2003, 14 Utah babies have died from shaking, Salt Lake Tribune homicide records show.

"He's someone who snapped" » Winter didn't die.

Two years after her daughter was shaken, Burpee wrapped the severely brain-damaged girl in a blanket and carried her into a Bexar County District courtroom as an exhibit in McKimmy's week-long trial.

"They uncovered the blanket," said Kurt Gransee, his San Antonio defense lawyer. "Then the jury and everybody started crying."

It was the worst case of his career, the attorney said. "After that, I said I would never do another one [shaken baby case.] It was horrible."

During his 911 call and in court, McKimmy said Winter had stopped breathing and he had shaken her to revive her, Gransee said. Pediatricians had noted in prior exams that Winter may have had sleep apnea.

But the state argued McKimmy had a prior history of abuse, and knowingly and intentionally hurt her.

The jury, unconvinced, found McKimmy guilty of the lowest possible charge. While the felony was punishable by up to two years behind bars, he instead walked out of court after the judge sentenced him to five years on probation and $10,286.25 in fines.

"I cannot condone what he did at all," Burpee said, "but is he a horrible, evil person? No. He's someone who snapped. To me, that's the biggest tragedy of shaken baby. It really, truly can happen to anybody. It doesn't just happen to people who abuse their kids."

Raising awareness » Utah is the first state in the country to implement the PURPLE Crying program in all 39 of its birthing hospitals. Staff at each hospital have been trained to deliver an 11-page PURPLE Crying booklet and a 10-minute DVD that teaches parents how to carry, comfort, or walk and talk with a crying baby.

Developed by Barr and her husband, Ronald Barr, it recognizes how unnerving a baby's cries can be and how helpless -- and sometimes angry -- this can make parents feel.

Now, with the help of a new $100,000 grant from Humana, the center is expanding its outreach to include pediatricians, health departments, home nurse visitors, adoption agencies, foster care facilities and the general public.

Prevention remains a challenge.

Between 2005 and 2008, the number of shaken baby cases seen in Utah jumped to 48 from 16 -- a 300 percent increase, said Lori Frasier, an associate professor of pediatrics at the University of Utah School of Medicine who culled the numbers for a national database being compiled.

Primary Children's Medical Center, along with a handful of other children's hospitals around the country, hope to identify trends by comparing cases. Frasier, who is the director of medical assessment at the Center for Safe and Healthy Families at the hospital, said they are collecting data that includes whether a baby was premature; if it was a part of a multiple birth; and details about abusers.

Abuse and economy linked? » The increase in shaken baby cases in Utah, Frasier believes, can in large part be chalked up to a growing population.

But something else is going on, too: Parents are more commonly leaving children with caregivers they might not have relied on before -- such as a neighbor or unemployed spouse -- because it's cheaper than full-time daycare.

That choice "makes sense -- unless that person (the caregiver) is stressed, or there are other reasons they're not very well equipped to take care of a baby," Frasier said.

Anecdotal evidence suggests child abuse cases are rising across the country in response to stress from the depressed economy, she said. A health care economist at the Children's Hospital of Pittsburgh is exploring a possible connection, linking shaken baby cases with zip codes, through which the federal government tracks unemployment.

Frasier said many of the cases she sees are rooted in poverty and drug abuse. One father who pleaded guilty to shaking his baby was only 17. Another was an immigrant who was in the country illegally, lost his job and was taking care of three children.

"We do see people who don't fit that profile periodically, but we see the majority of them have some types of stress," she said. "I've seen a lot of parents who feel like they need daycare so bad, they might not even know the last name (of their child's caregiver.)"

"I'll fight with her" » Winter is now 11 years old.

Doctors can't say if she is going to live until she's 20, her mother said. They can't say if she'll live until next year.

The weak, red-headed little girl functions at the same cognitive level as a 5-month-old infant.

She can't eat solid foods, so she is nourished through a stomach tube. She can't sit up or move her arms and legs, and sits hunched in a wheelchair. Her vision is spotty, but her hearing is acute. The tension in her body eases when her mother plays classical music. A familiar voice sometimes elicits a smile.

"In Wal-Mart, a little girl from her class came up to her and said, 'Hi, Winter.' And Winter just beamed at this child. I really think she recognized this girl," said Burpee, who eventually remarried and lived in Salt Lake City for nearly six years before relocating to Eagle River, Alaska.

When Winter turned 10 years old, "for me, that was an amazing, amazing moment, for her to have lived a decade," she said.

But Burpee will be honest: Her daughter's quality of life is poor. Unlike some parents who might aggressively seek therapy for their severely injured child, Burpee prays that Winter will go peacefully.

"Winter, give up and go home to Heavenly Father," Burpee has told her daughter. "Let go, honey. It's OK. You've fought this fight a long, long time."

But there is something that keeps Winter going.

"As long as she wants to fight," Burpee said, "I'll fight with her."