FINALLY- BBC: DOUBT over shaken baby diagnosis

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FINALLY.....

See my pages for the myths about Shaken Baby Syndrome

http://www.nccn.net/~wwithin/shakenbaby.htm

Friday, 26 March, 2004, 00:00 GMT

http://news.bbc.co.uk/1/hi/health/3564605.stm

Doubt over shaken baby diagnosis

Injuries may not mean abuse

Scientists have cast doubt over the theory that certain eye injuries are a

sign a baby has been violently shaken.

Experts believe that bleeding from the eyes probably indicates that an

infant has been physically abused.

However, a team from the US's Wake Forest University says there is little

hard science to support the view that this alone proves abuse.

Writing in the BMJ, members say assumptions about shaken baby syndrome need

to be challenged.

False allegations of child abuse could exist

Dr Lantz

Other experts said that bleeding from the eyes can suggest a baby has been

shaken violently - but the evidence is only compelling if there are also

signs of brain damage and bleeding in the brain.

The researchers focused on the case of a healthy 14-month-old child who was

brought to hospital with a severe head injury after a television fell on

him at home.

Despite the father's repeated, detailed, and consistent account of the

incident, Child Protective Services removed the child's three-year-old

brother from the home because the baby had injuries to the retina of the eye.

Only after a careful investigation by a paediatrician and a forensic

pathologist was the child's injury deemed to have been an accident.

The Wake Forest team searched the medical literature on the eye injury

observed in this case.

Members found no valid scientific studies to indicate that this particular

eye injury could only result from shaken baby syndrome - echoing the

findings of another recent study into the same topic.

No proof

Lead researcher Dr Lantz told BBC News Online: " It is important to

remember that this theory has been based on observations but has never been

proven.

" Also, no studies have been done comparing the presence of this eye injury

in shaken baby syndrome and serious accidental head injuries in young

children.

" If some doctors believe that this eye injury can only result from shaking

and haven't critically reviewed the medical literature, false allegations

of child abuse could exist. "

In an editorial in the same edition of the BMJ, forensic pathologist Dr

Plunkett and brain damage expert Dr Jennian Geddes argue the research

suggests that the criteria used to diagnose shaken baby syndrome require

re-assessment.

They say it is not unusual for shaken baby syndrome to be diagnosed on the

basis of signs of bleeding from the eyes alone.

" If the issues are much less certain than we have been taught to believe,

then to admit uncertainty sometimes would be appropriate for experts.

" Doing so may make prosecution more difficult, but a natural desire to

protect children should not lead anyone to proffer opinions unsupported by

good quality science. "

In a second editorial, Dr Harding and Dr Risdon, two experts

at Great Ormond Street Hospital for Children in London, argue that a

conclusion about a baby being violently shaken should only be based on a

careful examination of all the features of an injury.

However, they argue that if all three elements - brain damage and bleeding,

and bleeding from the eyes - are present, this is powerful evidence that

undue force has been applied.

" Damage to the neck or spinal cord is further useful confirmation, and the

presence of gripping injuries, while often absent, can provide further

weight. "

Disturbing findings

The Five Percenters, who support parents who say they have been wrongly

accused of shaken baby syndrome, said the findings raised " disturbing

questions " about the opinion of medical experts given in court.

Director Rioch -Brown, who was wrongly accused of shaking her own

baby son, said their study of parents' accounts of child injuries supported

other reasons for bleeding behind the eyes.

She said: " In approximately a third of cases their child's injuries

followed a minor fall, but both birth trauma and difficulty in breathing

can also cause bleeding under the skin and at the back of the eyes.

" Doctors have been so convinced that these injuries could only be caused by

shaking, they have simply ruled out the possibility that the parents might

be innocent after all. "

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