Shaken Baby Prevention In Maine: The Period of PURPLE Crying

Background: In 2007, pediatric care providers around Maine noted an increase in the number of cases of Abusive Head Trauma (AHT), more commonly known as Shaken Baby Syndrome.  These reports prompted the Maine Center for Disease Control to form a workgroup to address the issue.  From national and international published data and given our state birthing numbers of 14,000 babies per year, we would anticipate 4 to 5 cases of AHT per year.  Data presented in our state’s Maternal and Infant Mortality Review Annual Report indicates the following numbers of hospitalized cases.  “The number of children hospitalized for AHT fluctuated widely from year to year, from a low of 0 to a high of 9.  The number of initial AHT hospitalizations was lower in 2000-2002 (n=7) than in 2003-2005 (n=16) or 2006-2008 (n=16).”  Since AHT is a completely preventable event, providers recognized an opportunity to positively impact families and the community caring for infants.

Framework for the talk: 

A review of the literature identified two programs for serious consideration, one developed by Dr. Mark Dias in Buffalo, NY and the Period of Purple Crying (POPC), developed by the National Center on Shaken Baby Syndrome (NCSBS). Through a statewide, interdisciplinary workgroup the decision was made to use the Period of PURPLE crying materials.  Kelley Bowden, the Perinatal Outreach Nurse, together with Dr. Larry Ricci, child abuse pediatrician, began providing education to birthing hospitals, public health nurses, and home visitor programs in October 2008.  Over 300 hospital- based and public health nurses and physicians in Maine attended one of these educational sessions.  Another 600 providers have completed the on-line training available from the NCSBS.  All thirty birthing hospitals in Maine are delivering the Period of PURPLE crying materials as part of their perinatal education program for families.  The Abusive Head Trauma Prevention Workgroup is disseminating materials to primary care provider offices. The group continues to meet on a bi-monthly basis to discuss successes and challenges to maintaining the program.  Evaluation data will include monitoring the number of AHT cases per year and monitoring the birth statistics by hospital and the number of DVDs ordered by each facility.

Implications for practice:  

Abusive Head Trauma (Shaken Baby Syndrome) is a completely preventable event.  Nurses working with pregnant and newly parenting families are poised to provide brief education that is relatively inexpensive to implement.  This program has the potential to prevent death and serious injury to newborn babies.