With regard to the diagnosis of Shaken Baby Syndrome (SBS) Heather
Lohr asks, “Is the medical community still running on conjecture and
dogma? “
Sadly the answer is ‘Yes’.
I regret to say the “conjecture and dogma” is now not only in the
United Kingdom, Australia and the United States of America but has
manifested itself in India.
In one report, “the history of shaking, presence of intracranial and
retinal bleed and no coagulopathy allowed a firm diagnosis of shaken baby
syndrome to be made”
“The parents were directly and tactfully questioned regarding the
possibility of the child having been vigorously shaken, They admitted that
an elder sibling aged 5 years used to play frequently with his infant
brother and at times had been observed to have shaken him violently and
vigorously. The history of shaking, presence of intracranial and retinal
bleed and no coagulopathy allowed a firm diagnosis of shaken baby syndrome
to be made.”[1]
So now, to the “conjecture and dogma ” of SBS in the medical
community can added the activities of 5 year old children!
In another report, “among the wide spectrum of disorders presenting
as ALTE, child abuse occurs quite frequently. Presence of strong gender
bias in India highlights the necessity of suspecting abuse particularly in
all female infants who present with ALTE to the emergency.”[2]
Hopefully in the UK, USA and Australia the medical community will not
include “gender bias” as one of the “emerging concerns” they should be
aware of when called to see a child with Subdural and Retinal haemorrhages
[3]. But stranger things have happened in the UK, USA and Australia.
In neither report from India is mention made of the immunization or
nutritional status of the three infants involved. I have requested further
information from the principal authors and I am awaiting replies.
Michael Innis.
References:
1.Jayakumar I, Rangit S, Gandhi D. Shaken Baby Syndrome . Case
Report. Indian Pediatrics 2004; 41:280-282
2.Ray M, Ghosh D, Malhi P, Khandelwal N, Singhi PD. Shaken baby
syndrome masquerading as apparent life threatening event. Indian J Pediatr
2005;72:85-85
3.Report of the Working Party of the Royal College of Paediatrics and
Child Health November 2001
Rapid Response:
Re: Has any progress been made?
Editor,
With regard to the diagnosis of Shaken Baby Syndrome (SBS) Heather
Lohr asks, “Is the medical community still running on conjecture and
dogma? “
Sadly the answer is ‘Yes’.
I regret to say the “conjecture and dogma” is now not only in the
United Kingdom, Australia and the United States of America but has
manifested itself in India.
In one report, “the history of shaking, presence of intracranial and
retinal bleed and no coagulopathy allowed a firm diagnosis of shaken baby
syndrome to be made”
“The parents were directly and tactfully questioned regarding the
possibility of the child having been vigorously shaken, They admitted that
an elder sibling aged 5 years used to play frequently with his infant
brother and at times had been observed to have shaken him violently and
vigorously. The history of shaking, presence of intracranial and retinal
bleed and no coagulopathy allowed a firm diagnosis of shaken baby syndrome
to be made.”[1]
So now, to the “conjecture and dogma ” of SBS in the medical
community can added the activities of 5 year old children!
In another report, “among the wide spectrum of disorders presenting
as ALTE, child abuse occurs quite frequently. Presence of strong gender
bias in India highlights the necessity of suspecting abuse particularly in
all female infants who present with ALTE to the emergency.”[2]
Hopefully in the UK, USA and Australia the medical community will not
include “gender bias” as one of the “emerging concerns” they should be
aware of when called to see a child with Subdural and Retinal haemorrhages
[3]. But stranger things have happened in the UK, USA and Australia.
In neither report from India is mention made of the immunization or
nutritional status of the three infants involved. I have requested further
information from the principal authors and I am awaiting replies.
Michael Innis.
References:
1.Jayakumar I, Rangit S, Gandhi D. Shaken Baby Syndrome . Case
Report. Indian Pediatrics 2004; 41:280-282
2.Ray M, Ghosh D, Malhi P, Khandelwal N, Singhi PD. Shaken baby
syndrome masquerading as apparent life threatening event. Indian J Pediatr
2005;72:85-85
3.Report of the Working Party of the Royal College of Paediatrics and
Child Health November 2001
Competing interests:
Worried Grandfather
Competing interests: No competing interests