Edmonton tackles shaken baby syndrome
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* Heather Kent

Edmonton's Capital Health District has launched a campaign to prevent shaken baby syndrome (SBS, see page 155). Dr. Lionel Dibden, medical director of Capital Health's Child and Adolescent Protection Program, says an estimated 3 to 5 babies per million population are affected by SBS in North America, although “there are lots of kids who are shaken and don't come to our attention.” About half of the infants affected are under 6 months old, and the rest are under 2 years old. A recent national study concluded that 364 cases of SBS had occurred in Canada over the last decade. In the Capital Health region, 15 babies diagnosed with SBS were admitted to hospital over the past 3 years, and 5 of them died.

![Figure1](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/168/2/207.1/F1.medium.gif)

[Figure1](http://www.cmaj.ca/content/168/2/207.1/F1)

Figure. **Edmonton Oiler hockey player Georges Laraque has lined up against shaken baby syndrome** Photo by: Capital Health District

Dibden doesn't know if the incidence is increasing. “We are certainly more likely to make that diagnosis than we were 15 years ago. Today we certainly know what puts babies at increased risk and what might make it more likely that a particular person might lose control and shake a baby.”

Infants of isolated, stressed caregivers who have little money are at greatest risk, but Dibden stresses that SBS cuts across socioeconomic and ethnic lines. “Any of us is potentially at risk of shaking a baby.”

The campaign, which stresses that SBS often occurs because parents become frustrated by a baby's constant demands, is educating expectant mothers during prenatal classes and new mothers before discharge from hospital and during postpartum visits by nurses. “The message we are trying to deliver is that parenting is a tough job,” explains Dibden. “When the stresses are greatest, parents need to be aware that it's OK to put the child in a safe place like the crib, leave the room, take a break and regroup for a few minutes.

“When you eventually go back, you are much more likely to be able to deal with it and not harm the child.”

Health professionals who work with families and the police are taking part in special SBS seminars. Dibden hopes this will give the program staying power “because we are embedding it in people's jobs.” Physicians are also being educated, because SBS babies may present with nonspecific problems. Health Canada will soon be releasing guidelines on the syndrome.

“It's an entirely preventable cause of death and severe brain damage,” says Dibden, “but we need to build the supports before we get to that point.” — *Heather Kent*, Vancouver