ST. GEORGE — It only takes four to five seconds of shaking an infant to cause serious injury, and more than 1,300 cases of this cataclysmic form of child abuse are reported each year. Three such cases have been reported in Southern Utah in recent months.

The most recent incident, reported less than two weeks ago, involved a 4-month-old infant who was admitted to the hospital with intracranial bleeding and bi-lateral retinal hemorrhaging, injuries authorities were told by the child’s treating physicians were consistent with “shaken baby syndrome.”

The infant’s mother reportedly told officers she was attempting to stop the infant from crying by placing both hands around the infant’s chest while bouncing and rocking the baby “aggressively,” the report states, without holding or supporting the infant’s head as she did so. Immediately after the incident, there was a marked change in the infant’s behavior. The baby was taken to St. George Regional Medical Center before being flown to Primary Children’s Hospital in Salt Lake City. The infant has since been released from the hospital but the long-term effects of the injuries are not yet known.

In December, a 7-week-old infant suffered a severe intracranial traumatic injury that was reportedly caused by a sudden, external, physical force, which caused the brain to strike the inner surface of the skull that disrupted normal brain function. This was followed by a secondary injury caused by a lack of oxygen or a disruption in the oxygen flow to the brain.

The baby began having multiple episodes of twitching and jerking followed by periods of limpness and unresponsiveness and was transported to the hospital by ambulance and then flown to Primary Children’s Hospital. The report also stated the infant had no history of any injury or reported head trauma, which led treating physicians to conclude that “abusive head trauma or severe child physical abuse” must be considered as the most likely cause of the injuries.

In October, a 23-year-old man was sentenced to prison for an incident that took place in Brian Head five months prior involving a 2-month-old baby. According to court records, the infant was admitted to the hospital for treatment of extensive injuries, which included bleeding of the brain and multiple broken ribs and leg fractures, injuries consistent with shaken baby syndrome, according to information provided to authorities from the infant’s treating physicians.

Although the baby’s injuries were critical, she survived. However, the long-term effects and extent of the damage have yet to be determined, and treating physicians noted the child may have some blindness, particularly in her right eye, as a result of the brain injury she sustained.

Shaken baby syndrome is catastrophic 

It is difficult to determine the exact number of shaken baby cases there are each year since many are underreported or never receive a diagnosis; however, the National Center on Shaken Baby Syndrome estimates there are approximately 1,300 reported cases of abusive head trauma, which is also the leading cause of physical child abuse deaths in the United States.

More than one-quarter of these children die from their injuries and 80% of those that survive suffer lifelong disabilities. It only takes a few seconds of violent shaking to cause permanent damage that can leave a child with cerebral palsy, retinal stretching and tearing that can lead to blindness, hearing loss, learning and behavior problems, as well as seizures and paralysis.

The center also states that an infant crying is the no. 1 trigger, and babies under the age of one are at the highest risk.

Cases involving injuries sustained by shaken baby syndrome are “some of the most devastating and heartbreaking cases we see,”  Dr. Gary Bosshardt, a physician at Intermountain Healthcare’s Sunset Clinic told St. George News.

Bosshardt, or “Dr. Gary” as he is affectionately known by his patients, said the injuries sustained in the wake of this type of abuse can be catastrophic, and what makes it even more devastating is it is “100% preventable.”

What happens when a baby is shaken 

Bosshardt explained that when an infant is shaken, there is a rapid acceleration and deceleration in the movement of the head – a traumatic event that often severs blood vessels and can cause bleeding and swelling. This can lead to severe neurological damage or even a stroke, where the infant is left in a vegetative state, paralyzed or, in some cases, results in death.

The injuries can also lead to conditions or impairments that can last a lifetime.

The signs of this type of abuse are not always visible, he said, and sometimes it takes social cues that are detected when a child is brought in by a caregiver or parent for treatment. He said when a baby has been shaken, the child typically presents as being extra fussy or tired, sometimes lethargic, all of which can be indicators that the brain has suffered some type of traumatic injury.

Other injuries associated with shaken baby syndrome include bruising around the neck, head or the back of the legs, he said, as well as fractures physicians do not typically see in younger infants, such as fractures to the ribs, head or legs. It is also not uncommon to see liver damage in the blood work of an infant.

In many cases the injuries reported are not consistent with the mechanism of injury, such as an injury from an activity the infant is not developmentally capable of achieving, he said.

“Basically when the story doesn’t match the injuries – that is reason for pause,” he said.

There are also social cues that are typically present when a caregiver seeks medical help for a child who sustained injuries that could be by abuse. They can be overly protective of the child and not allow the doctor to properly examine the infant, he said, or they can be very aggressive with the physician or anyone who tries to come near the child. He also said that statistically, a vast majority of these cases involve the father or other male.

Underlying causes that can trigger abuse 

Bosshardt said there are several factors that are commonly present and can push a parent or caregiver over the edge. There are situations when a person is unprepared to take on the responsibility of parenting and is in no way equipped to care and provide for an infant. If a parent who is already overwhelmed encounters the added stress of a crying infant, they can make a split-second decision, which can result in catastrophic consequences.

Add to that, he said, the changes that have been brought about by the COVID pandemic, including unemployment, isolation, a drop in family income, as well as other stresses associated with any major shift, can leave a parent with very few coping skills. This in turn can also make people more reactive in their response.

“It would be fair to say that most parents don’t wake up thinking, ‘I’m going to hurt my child today,” he said.

To that end, Bosshardt mentioned that Intermountain Healthcare recently launched an initiative to address the social, familial and economic factors that can significantly impact both the physical and mental health of a parent or caregiver. The reasoning behind the initiative is that very little of what determines the health of an individual actually has to do with medical care.

It has more to do with what happens outside of the physician’s office in terms of living conditions, the person’s support network, income and employment issues, and so on. The impact on the mental and physical health caused by the stress is what typically brings the person to the hospital, and in some cases, it is the children who are brought in with injuries sustained by abuse.

Intermountain Health Care’s Community Health Initiative 

The Community Health Initiative was created using data from our 22 local hospitals to develop a health needs assessment designed to identify local area health needs that are specific to that region. Those findings are then used to create an implementation strategy to address the health needs of that particular community.

St. George News reached out to Amber Rich, community partnership specialist with the Community Health Initiative who said the program was launched to address the needs of the community, many of which have been on the rise since the pandemic first hit, she said, including housing, food and other basic needs.

The changes triggered a shift in society, which can also have a negative impact on the emotional and mental health of an individual – for parents, those effects can be compounded – particularly for those families that may be experiencing excessive hardship.

In many cases, the first point of contact for someone experiencing mental health or coping issues takes place during a visit to the doctor or emergency room.

With that in mind, primary care and emergency physicians are now asking different questions that are related to housing, food and other social and family needs to determine if there are deficiencies or support that is needed, instead of limiting their questions to the reason for the visit.

Rich said struggling families can get the help they need through a vast array of resources for assistance once the issues or deficiencies are identified during a visit.

Resources for overwhelmed parents and struggling families 

Numerous agencies and programs are available across the Southern Utah corridor, which includes mental health integration services provided through Intermountain and the Southwest Behavioral Health Center.

Sarah Wellover, spokesperson for the Department of Children and Family Services, told St. George News parents who are struggling can also reach out to Help Me Grow Utah for information.

Rich said another resource is the Family Support Center, which provides crisis and respite care for children as well as parenting classes and other resources to help a parent or family in crisis. The center also operates a 24-hour crisis hotline that can be reached at 435-773-0585.

The Root for Kids program is a nonprofit organization that provides resources such as parenting education to providing assistance for special needs children, as well as many other resources to help a struggling family.

The Five County Association of Governments is a voluntary association of local governments from the five southwestern counties across Utah, including Beaver, Garfield, Iron, Kane and Washington. The agency has resources to help stabilize low-income households and assist with transportation, housing, employment support and also offers childcare resources.

The Centers for Disease Control also has a guide to help parents identify triggers and risk factors associated with shaken baby syndrome; available here.

211 Utah 

The program, 211 Utah, is offered by the United Way and is a free, confidential service that links the caller to the help they need through an array of organizations throughout Utah. The program can also be accessed using a mobile application that can be downloaded onto a cell phone.

Rich said that all of these agencies, and many others, can be accessed using the 211 service.

The caller is connected to a referral specialists that has access to a myriad of resources – both from private and public health and human service agencies. The services are then matched to the needs of the caller, either by referral or by a direct link to the agency or organization that can help.

Bosshardt said that addressing some of the root causes that can lead to child abuse is important, and the goal is to prevent abuse before the child ends up at the hospital with a catastrophic injury.

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