Shaken baby deaths persist

ALBANY — Gregory Milgo was a new father. When his 4-month-old son, who was born prematurely, wouldn’t stop crying, he shook the baby.

The baby stopped breathing and Milgo called 911. The baby was rushed to St. Peter’s Hospital and transferred to Albany Medical Center, where he later died. At the time of his death in May, he weighed 7 pounds and had suffered brain injuries, broken leg bones and fractured ribs.

Milgo, 29, of Albany, who told police he grabbed the baby by the midsection and shook him numerous times to stop his crying, is serving 18 months for manslaughter.

It’s not an uncommon scenario.

Dr. Javier Sanchez, director of the pediatric intensive care unit at Albany Medical Center Hospital, estimates that he’s treated approximately 500 infants and children who suffered from shaken baby syndrome or non-accidental head trauma in his 17 years at the hospital.

In this past year alone, at least two infants treated for shaken baby syndrome at the hospital have died.

Shaken baby syndrome describes a group of injuries that result from a child being violently shaken by another individual. The American Academy of Pediatrics describes the severity of the shaking as so violent that competent individuals observing the shaking would recognize it as dangerous.

There are an estimated 1,000 to 3,000 cases of shaken baby syndrome each year in the U.S.

Injuries associated with shaken baby syndrome include traumatic brain injury, retinal hemorrhages, blindness, fractures, seizures, paralysis and death.

Quieted forever

“We get a case once every 10 days,” said Sanchez, who said the No. 1 reason for shaking a baby is inconsolable crying.

A caregiver becomes frustrated, loses control and shakes the baby to stop the crying. There is usually no intent to harm the child, and most often, the caregivers do not know that shaking is harmful to the infant, he said.

Ulli T. Neuwirth of Guilderland was charged earlier this month with second-degree assault and endangering the welfare of a child when his daughter suffered brain injuries and broken legs after he allegedly shook her over a period of several days. He told police his fuse had grown shorter and he wrote his daughter an apology.

Officials say that when the perpetrators talk about what occurred, they often say they were just trying to get the child to be quiet.

“Usually the child is crying, they feed him, change him and he keeps crying,” said Sanchez. “The crying gets worse. If they have stressors, they take it out on the little one.”

Men in their early 20s are the perpetrators in 80 percent of shaken baby cases, according to the Health Department. The abuser is usually the baby’s father or the mother’s boyfriend. Female perpetrators tend to be a caregiver other than the biological mother.

Because of poor muscle development in an infant, the head will shake back and forth. It’s not necessary to strike the infant or child on a hard surface to cause severe injuries. They can occur even if the infant is slammed down onto a mattress.

In Troy, 26-year old Adrian Thomas was charged with murder in September after he threw his 4-month-old son onto the bed three times in a two-week period, causing traumatic brain injuries that led to his death.

Many parents who bring in an injured child will tell doctors that they had started CPR on the child and performed chest compressions — when they never did — to try to explain broken ribs on the child, he said.

An infant or child might come in for a convulsion, said Sanchez, but there is blood and retinal hemorrhages, another indicator of shaken baby syndrome. Or the baby might have had a life-threatening event and while there are no visible signs of abuse, a CAT scan will show brain injuries.

According to published reports, approximately 25 percent of infants and children who require medical attention for shaken baby syndrome will die, said Sanchez. At Albany Medical Center, the death rate is closer to 10 to 15 percent, he said.

Psychological factors

Dr. Rudy Nydegger, clinical psychologist in Schenectady, said every case is different and there is no uniform set of factors leading up to it.

“Someone is losing control and taking pretty severe action against a child that results in a serious injury or death, and whether or not the person intends to do it, it’s an extreme reaction,” Nydegger said.

He said when perpetrators describe their actions, most seem to have considerable remorse or wish they hadn’t done it, and they almost always talk about frustrations that they can’t quiet the child. Often they don’t know what else they can do and they just snap. Others will say the child deserves it because of how they were acting.

One risk factor is substance abuse, said Nydegger, who said people are more likely to take violent action if they have less control of themselves. If the person is stressed out, they may be more likely to have a drink, which decreases their ability to control their behavior.

In some cases, the perpetrator has very little knowledge of how to care for a child.

“It’s terribly important to ensure that people in charge of a child know what to do,” said Nydegger.

Ask for help, said Nydegger.

“Call someone. Call a friend, neighbor or relative. People are usually happy to help, especially if someone is at their wit’s end,” he said. If you don’t know who to call, call Social Services.

Keeping control

The advice to caregivers is to take a time out, not for the child, but for yourself.

“If he [the baby] is colicky, feed him and change him. If he continues to cry, put him in the crib and walk away until you get yourself under control,” said Sanchez.

The Health Department offers tips for dealing with a crying baby, including:

Check to see if the baby needs changing or is hungry; feed slowly and burp often; check to see if the baby is too hot or too cold; rock the baby; run a vacuum cleaner within hearing range of the baby; give the baby a pacifier or let the baby nurse; play soft music, sing or hum; take the baby for a ride in a stroller; put the baby in a baby swing or vibrating bouncing seat; strap the baby into a child safety seat and take the baby for a ride in the car; while sitting, lay the baby face down across your knees and gently pat or rub their back; place the baby in their crib for a few minutes, where they may calm down on their own.