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Children are at greatest risk for abusive head injuries between about 2 weeks and 4 months of age, when they cry the most and cannot always be soothed.

It’s well understood that head injuries are harmful to children, but just how serious are the effects?

A new study published in Pediatrics reports half of children who experience a severe abusive head trauma before the age of 5 will die before their 21st birthday. The study, led by Ted Miller of the Pacific Institute for Research and Evaluation, also reports the quality of life of children who survive severe head injuries is cut in half.

Dr. Kenneth Feldman, a primary care doctor at Seattle Children’s Hospital and former chair of the hospital’s Child Protection Program, was not surprised by the results of the study.

“These findings are in line with what we’ve experienced in clinical care,” said Feldman, who is also an investigator with the Center for Child Health, Behavior and Development at Seattle Children’s Research Institute. “Abusive head injuries have devastating affects. We know that of the infants that survive these kinds of head injuries, about a third develop life-threatening neurological disorders, another third have moderate dysfunction and the remainder appear healthy, but may experience significant problems in school.”

Abusive head injuries occur when an infant or toddler is shaken and suffers blunt head trauma. In the United States, at least 4,500 children suffer from preventable abusive head injuries each year. Children under 5 years old are most likely to experience this kind of abuse, and are more likely to die from it, according to the study.

Children are at greatest risk for abusive head injuries between about 2 weeks and 4 months of age, when they cry the most and cannot always be soothed. This period can be especially frustrating to parents, Feldman said.

“It’s not unusual for people to lose their temper with an infant,” he said. “Parents should anticipate that their child could go through a phase where they are fussy and cannot be comforted. Babies just need to cry. When you get frustrated, it’s better to put the child down in a safe place and walk away than act out aggressively.”

The community can also play a role in preventing abusive head trauma by supporting new parents, Feldman said.

“Parents of new babies need help,” he advised.  “Friends and families should rally around a new family as much as possible and offer support before and after the baby is born.”

If you suspect a child has been shaken or abused, it’s important to report it immediately to law enforcement or child protective services, Feldman said.

“Subsequent injuries can be especially harmful to children, so it’s important to report the first signs of abuse,” he said. “We’d much rather see infants with some minor bruising rather than seeing them three weeks later with fatal head injuries.”

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