Dead Babies...To Get It Off My Chest

eriksoln, BSN, RN · Feb 16, 2009

The kinds of catastrophic damage that occur in shaken baby syndrome come from what are called rotational forces--rapid and repeated whiplash-type motions that end up shearing neural connections, rupturing tiny blood vessels, and literally scrambling the infant's brain.
Playful plopping or even simple falls result in a linear force, which, while it does have the potential to do damage, is nothing like the devastation that occurs with shaking a baby.
I'm guessing the OP mentioned the earlier shaking information to point out a possible pattern. Two things come to mind. One is that if you have that kind of temper and you have responded by shaking in the past, you are predisposed to act that way again. And two, a baby who has brain damage (even if it isn't readily apparent) from prior shaking may not need much more force to finish the job.
This situation is indescribably sad. But to answer your question, parents can engage in normal bouncy play, though they do need to exercise some common sense. Simply plopping a baby on her bum to make her laugh will not destroy her fragile brain. Shaking her back and forth like a rag doll, on the other hand, can turn her mind to mush and steal every chance she has for a normal future.
The lucky ones die.

Oh, Ok. Thank you. Its a touchy subject. I'm a little embarassed for even asking.

So, one who is carefull and displays some common sense doesnt have to worry so much. Simple play does not bring these things on.

Hmmm. That is sad. That someone could intentionaly do this. Dont even know where to go with that.

leslie :-D · Feb 16, 2009

It could very well have been a child care provider or someone else that inflicted the injury to the child. Just something to think about before calling the mother a "putrid bucket of pig slop". She could quite possibly be an innocent grieving mother who just lost her beloved child!!

whoever it is, i agree he/she is a 'putrid bucket of pig slop'.

it's not so much who did it, but that someone did it at all.

may they rot in hell.

leslie

HM2VikingRN, RN · Feb 16, 2009

Its why I can't work PEDS.....Too many chances for a PTSD injury.....Get counseling and don't let this fester. Thanks for doing what you do!!!!!!!!!!!!!!!

Altra, BSN, RN · Feb 16, 2009

{{{{Hugs}}} to you, OP.

rn/writer, RN · Feb 16, 2009

Oh, Ok. Thank you. Its a touchy subject. I'm a little embarassed for even asking.
So, one who is carefull and displays some common sense doesnt have to worry so much. Simple play does not bring these things on.
Hmmm. That is sad. That someone could intentionaly do this. Dont even know where to go with that.

No, no, you don't have to be embarrassed. You had a legitimate question, one that I'm guessing a lot of people have wondered about but were also reluctant to ask.

As for simple play not bringing on shaken baby-type injuries, think about all the stuff normal kids go through. They roll off beds, get picked up and dropped by their three-year-old sibling, tumble forward out of an infant seat. Even just falling over backward from sitting up can produce a good-sized lump on the noggin. Before walkers were outlawed, it was a regular occurrence for a kid riding in one to take a tumble down the basement steps and land on the concrete floor below. Incidents like these produced head bonks and screaming kids, but the only ones shaken were the parents.

That's because these were all straightforward uni-directional injuries where the biggest result was a contusion or perhaps a concussion that would heal without lasting damage. (Yes, there was the occasional skull fracture, but they were rare.) Shaken baby syndrome is different in that it is a repeated assault on, and insult to, the brain tissue that, as I mentioned earlier, destroys the neural pathways and microvasculature of the entire brain. Instead of a localized bump or bruise, you have irreversible disruption that is every bit as catastrophic as a major stroke. Kids rarely come back from this, and when they do, they almost always have serious deficits.

I don't want to minimize the importance of keeping kids safe from head bonks. But it's a rare kid who makes it to grade school age without at least one goose egg. There's a big difference between having your bell rung and having your brain permanently scrambled.

I'm really glad you asked this question. Thanks.

prowlingMA · Feb 16, 2009

All of this happens and yet my sister a foster mother has to wait three years to adopt the baby she has raised since he was 4 months old, because the drug addict molesting mother might turn around and get him back.

The other child from this family is so abused and mentally disturbed she is in a treatment facility at 7 years old. What kind of monster can mess up a 7 year old so bad they try to cut other people and hurt themselves so much cops had to be called to restrain her.

She goes for another hearing this week.

Long Term Care Columnist / Guide · Feb 16, 2009

This is one of the reasons I chose to work with folks at the other end of life. These are men and women who have had a chance to live full lives, and when they die, it's usually a blessing because their minds and/or their bodies have worn out. By contrast, when events rob babies and children of their chance to live and grow up, I consider it a tragedy of the worst sort...........and when those events are induced by the adults who are supposed to love and care for them, it is a crime against nature that is too monstrous to be borne.

I salute the OP for controlling the savage fury that would probably have landed a lesser mortal (such as myself) in prison for life. Keep talking about it, you desperately need to decompress after such a horrendous experience. You are in my thoughts and prayers, as are all who must deal with these tragic incidents.

caddismt · Feb 16, 2009

Thank you for all of the replies...have learned that both "mom and dad" will be charged in this case. It frustrates me that this slipped through the cracks.

Thanks again everyone.

Pediatric Critical Care Columnist · Feb 16, 2009

I've worked in peds critical care for nearly 12 years and have seen many horrible situations. There was a 2 week period about 10 years ago when our unit admitted 3 little 9-month-old girls, all shaken by their primary male caregiver... their dads. For a brief period they were all in the unit at the same time. All 3 of these precious little girls died. All 3 of these men pleaded guilty to manslaughter and spent time in jail. None of these men had a pattern of abuse against their children... but they did have poor coping skills when faced with a crying infant and a poor understanding of the effects of shaking. By contrast, the animal who tore the orifice and stomped on the abdomen and chest of another 9-month-old girl, the first abused child I cared for, had to know that what he was doing was wrong.

Statistics suggest that the majority of abusers are primary male caregivers, most often the mother's boyfriend (but NOT the biological father). Anecdotal evidence also suggests that in many cases, the mother has no idea the abuse is occurring, at least initially. She leaves the child alone with her boyfriend for periods of time thinking the baby is safe. The ones who discover the abuse but choose to stay with the offender are the ones who deserve our contempt.

Shaking her back and forth like a rag doll, on the other hand, can turn her mind to mush and steal every chance she has for a normal future.
The lucky ones die.

Miranda is so right about that. Shaken babies who survive will have severe disabilities ranging from blindness, deafness, spastic cerebral palsy, dysphagia, airway management problems, cognitive and expressive deficits and a host of others. They are also at high risk of further abuse because of their disabilities.

Wheeled baby walkers may have been banned, but they're still out there. Last year we had a little one who went down the basement stairs in one. Only the wheels caught on the stair edging partway down the flight and the baby was catapulted out of the walker. He landed on the concrete floor, fracturing his skull and eventually causing his death.

Of course, all of this is very interesting, in a morbid sort of way. But it doesn't really address the OP's feelings. The suggestions of other posters regarding debriefing are all very important. Please talk to someone. It doesn't have to be a formal conversation with chaplaincy, EAP or some other sort of counselor, but it should be with someone whose attention and advice are valued by the OP. Don't try to compartmentalize the experience yet. Acknowledge that this is a horrible thing, that you did your job to the best of your abilities, that despite of everything the baby died, and remember that we cannot (and should not) save everyone. There's no shame in asking not to be in the room with peds cases for awhile. Soon enough you'll feel more able to face it again. It should never be easy... it's our humanity that makes us effective as nurses. :redbeathe:heartbeat:redbeathe:heartbeat

RNKel, ASN, RN · Feb 16, 2009

Shaken Baby Syndrome statistics revealed that 50% of offenders are natural parents, 17% are the mother’s boyfriend, 17% are non-relatives, and 6% are step parents. Though shocking but true, most perpetrators are the parents themselves.

PICNICRN, BSN, RN · Feb 17, 2009

Unfortunately, I've seen this same senario happen over again in my career- "suspected non accidental trauma" comes in- investigation is done- can't make a good case against anyone- parents aren't fessing up-blaming the sitter- whatever. CPS "can't" remove the kid but "will follow up".

Kid lives and is sent home with the parents only to come rolling in again within the year seizing/unresponsive/whatever and finally their nightmare of a life is over.

Makes me SICK!! Fact of the matter is the "system" is broken and kids are the ones who suffer because of it.

Try to think that this little angel is in a better place and will no longer suffer. And like others said- maybe you could have a debreifing? Hugs to you! Sorry about your rotten day.

platon20 · Feb 18, 2009

Let me clear up some things about shaken baby syndrome.

This is NOT a little accidental shake like you would shake your toy doll playfully. The perpetrators of these crimes have been interviewed after the fact and some of them agreed to document to a camera exactly how hard they were shaking hte baby by using a toy doll. I've seen those videos, and they are absolutely shocking. Its incredibly violent shaking, not just a playful shake or two that causes these injuries.

Think about grabbing a pillow and shaking it as hard as you can with every muscle in your upper body. THATS what causes shaken baby syndrome, not just a little playful shake or two.