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STOP! And just walk away

Editor's note: This story is part of a joint effort by the Mail Tribune, KOBI Channel 5 and the Jackson County Child Abuse Network to educate the public about the extent of child abuse locally and what Rogue Valley residents can do about it. This is the last of four stories published in April as part of Child Abuse Awareness Month.

When trying to soothe a steadily screaming baby drives frustrated parents and caregivers to their breaking point, the result can mean injury or even death for the infant.

That is why a new educational effort, known as the Period of PURPLE Crying program, is spreading throughout Rogue Valley hospitals, schools and childcare centers.

One of the teaching elements is a 10-minute DVD being given to every new mother at all four Rogue Valley hospitals. The DVD explains normal infant crying, offers ways to reduce stress related to the crying and informs them of the dangers of shaking an infant.

Designed to stop child abuse triggered by the stress of inconsolable infant crying, the message is simple: Stop, breathe and reset your mind.

People think they would never harm their child. But statistics show the No. 1 trigger for child abuse is crying, said Dr. Kerri Hecox, medical director for the Children's Advocacy Center in Medford.

"Maybe you wouldn't shake your baby," said Hecox. "But everyone gets frustrated. And it's important to have a plan for what you're going to do to calm yourself down before you do any harm. People need to know it's OK to put the baby in a safe place and walk away for a bit. Listen to music, do exercise or write in a journal. Whatever helps bring yourself down."

An estimated 1,200 to 1,400 children are injured or killed by shaking every year in the United States. There are currently one shaken baby case and two "serious physical abuse cases" (broken bones) involving infants in Jackson County. In two of these cases the perpetrators admitted that the babies were crying when they injured them, Hecox said

"One woman said the baby was 'crying, crying, crying,' " Hecox said. "She admitted she pushed the baby's leg back further than she knew it could go while she was changing a diaper."

The frustration resulted in a leg fracture for the child, Hecox said.

Parents and caregivers need to know three things about inconsolable crying: It is normal, it is not their fault, and it will pass, said Dr. Russell Barr, researcher for the National Center on Shaken Baby Syndrome.

Known as the period of PURPLE crying, the cycle begins in the first month, peaks during the second month and tapers off at the end of three months. This is true across all cultures and in all countries. Inconsolable crying behavior in infants is the norm. "High crying" babies will have more episodes. Others will have fewer. Tragically, closely shadowing the crying curve is the number of incidents of shaken baby syndrome, Barr said.

Researchers may know inconsolable crying is normal behavior for all infants, particularly during the first three months of life. But most parents are unprepared for their infants' crying jags, which can range from 20 minutes a day to five hours a day, said Dottie Olivera, a registered nurse at Providence Medical Center's BirthPlace. "That is quite a 'normal' range," said Olivera.

Caring for an infant who has hours-long inconsolable crying periods is stressful for parents — even medical professionals who care for babies as part of their job.

Olivera has seven children. Her last child, now 15 months old, cried for three to four hours a day during those early weeks, she said.

"All my other babies were 20-minute babies," Olivera said. "If I had only known this was normal, it would have made things so much easier on everyone."

Olivera said she is happy to show the DVD to the mothers of the 40 to 70 babies born each month at the birth center. And they urge the moms to make sure everyone who will care for their baby also watches.

"We tell them to say 'it's nurse's orders,' " she said.

Southern Oregon University nursing students have taken the awareness program out into the Teen Parent Program at North Medford High School, Magdalen House and Head Start. And there are plans to expand into general health classes in all high schools, Hecox said.

"We know a lot of teens are babysitting their younger siblings or for a job," she said. "This helps them understand the dangers and techniques. It also plants the seed for when they have their own kids."

One of the teen teaching techniques involves a doll that is programmed to cry nonstop for 30 minutes. During the relentless crying, instructors show teens how to swaddle, rock and sooth a baby.

"Then someone asks, 'Is anyone stressed about this crying?' " Hecox said.

Hecox said adults often are reluctant to admit it is stressful to hear a baby cry. Frustrated caregivers may feel that shaking a baby or small child is a harmless way to make the child stop crying. One father in the Dads Program run through OnTrack, stated his confusion, she said.

"He said 'I didn't know it was OK to put the baby down and walk away,' " Hecox said.

Approximately 25 percent of babies with the syndrome die as a result of their injuries. Of those who survive, 80 percent suffer permanent disability such as severe brain damage, cerebral palsy, mental retardation, behavioral disorders and impaired motor and cognitive skills. Many survivors require constant medical or personal attention. Medical costs associated with initial and long-term care for these children can range from $300,000 to more than $1 million.

Reach reporter Sanne Specht at 541-776-4497 or e-mail sspecht@mailtribune.com.

Dr. Kerri Hecox, medical director for the Children's Advocacy Center, says the No. 1 trigger for child abuse is crying, prompting social service agencies to educate new parents on ways to cope. - Bob Pennell