Shaking alone may not be responsible for damage

EDITOR,—It is good to be reminded by Helen Carty and Jane Ratcliffe of the need to recognise intentional injury as a cause of morbidity and mortality among infants.1 It is dissatisfying, however, to find that this reminder is based on “shaking”—an ill defined action whose sequelae do not seem to be as firmly established in the literature as the authors would have us believe.

I am surprised that the authors make no reference to the work of Duhaime et al, which raises the question of whether the forces generated by shaking alone are sufficient to …