1. Shaken Baby Syndrome Prevention Training for Child Care Providers

2. Activity: Let’s get acquainted

3. Prevent Violence Against Children Act (Shaken Baby Syndrome Act)

4. Activity: Learning to relax

5. Activity: Learning to relax (cont.)

6. All babies cry Crying is normal. Babies cry for many reasons. ALL babies will have times when they CANNOT stop crying.

7. Babies cry to communicate Quotes about  12-year-old2-month-old Hunger“When’s dinner? I’m starved.” Discomfort“I’m not wearing these dress pants. They’re too tight.” Over-stimulation“Leave me alone.” Under-stimulation“I’m bored. There’s nothing to do.” Fatigue“I’ve had a long day” “CRY!”

8. Normal infant crying Adapted from the NCSBS and Ronald G. Barr, MDCM The amount of crying: Changes over time Varies among normally-developing babies

9. The period of PURPLE crying From the NCSBS and Ronald G. Barr, MDCM Peak pattern Unpredictable Resistant to soothing Pain-like face Long bouts Evening cry

10. What is colic? “Colic” suggests intestinal distress Is something medically wrong with the baby? Is the baby in pain? Does “infant colic” simply refer to a baby that cries a lot?

11. What if the baby cries a lot? “Colic” is extreme, but normal, crying. Crying will greatly decrease by the time the baby is 3 to 4 months old. Colicky infants show no lasting harm. Get help if the crying is a problem for you or the baby. Normal doesn’t mean easy!

12. Same baby ─ same day

13. The crying game

14. Soothing a baby Feed baby slowly and burp baby often. Make baby as comfortable as possible, for example, check temperature and diaper. Provide gentle motion or relaxing sound. Is baby hungry? Thirsty? Bored? Anxious? Sleepy? Understand that all babies have times when they cannot stop crying.

15. Pre-anger Heating up Before boiling over Don’t let yourself boil over. Anger

16. Anger workout Accept Name Get it out Energize Resume

17. A tired, frustrated caregiver and a crying baby can be a deadly combination leading a parent or other caregiver to shake a baby in a moment of frustration.

18. Shaken Baby Syndrome (SBS) What is it? SBS is a medical term used to describe the injuries that can result if a baby is violently shaken. The younger the baby, the greater the risk of harm. Violent shaking is one of the most devastating forms of child abuse.

19. Shaken Baby Syndrome (SBS) What is it? (cont.)

20. Early symptoms of shaking Irritability Lethargy, sleepiness Feeding problems Vomiting Dilated pupils Poor muscle tone Pale or bluish skin Seizures Not breathing Loss of consciousness

21. Other physical signs Rib fractures Fractures of long bones in the arms or legs External wound or bruise to head

22. Emergency response Call 911 If the child stops breathing, begin CPR. If the child is vomiting, turn the child to prevent choking or aspiration. Do NOT pick up or shake the child!

23. What is the result? Even with prompt medical attention many victims die. Those who survive may have:  Blindness  Paralysis  Deafness  Broken bones  Learning disabilities  Coordination problems  Developmental challenges  Seizures The most common reason given for shaking a baby is that the baby wouldn’t stop crying.

24. Risk factors for being a victim Age Gender Greater demands for care, for example illness, pre-maturity, or other special needs of some kind

25. Anyone, but some people are more at risk: Parents and other caregivers Late teens and early 20s Males People with other risk factors – drug and alcohol use, mental illness, lack of self-control, inexperience with babies, high stress Who would shake a baby?

26. When a baby can’t stop crying Try different ways to soothe the baby. Know that a comforted baby doesn’t always mean a quiet baby. Know that crying isn’t always a sign that something is wrong. If at anytime you start feeling tense or frustrated, it is important for you to take a break.

27. It is more important to stay calm than to stop the crying Put the baby in a safe place. Shut the door. Leave for 10- to 15-minutes. If you are calm, try again to soothe the baby. If you are not calm, seek help. Call someone. Babies cry. Have a plan.

28. Activity: Difficult developmental phases

29. Activity: Self-calming brainstorm

30. It’s okay to ask for help Someone who can come over right away and help The baby’s doctor, or nurse helpline Local community resources Have the phone numbers of people who can help when the crying is too much.

31. Activity: Building a support system

32. “Portrait of Promise” DVD

33. Babies cry. Have a plan… To soothe the baby To calm yourself For who you can call for help

34. Remember… All babies cry. It is more important for you to stay calm than to stop the crying. Plan ahead for who you will call when you need help. Never shake a baby for any reason. Babies cry. Have a plan.

35. http:wctf.state.wi.us A special thanks to the Alberta, Canada, Shaken Baby Syndrome Prevention Network for generously sharing materials and expertise.