A Rebuttal to the Joint Statement on Shaken Baby Syndrome

[Guest guest]

A Rebuttal to the Joint Statement on Shaken Baby Syndrome,

Minister of Public Works and Government Services, Ottawa, 2001.

Harold E Buttram, M.D.

November 27, 2001

Introduction:

At the present time there is a concerted international campaign to train

and mobilize health services, child welfare, police services, justice,

education, social services, and other organizations in the

identification of child abuse under the general term of shaken baby

syndrome, the frequent end result being the accusation and conviction of

parent or caretaker of this crime through the court systems. The Joint

Statement on Shaken Baby Syndrome (SBS), cited above, is a typical

example of this campaign. These accusations and convictions are largely

centered in the United Kingdom, Australia, Canada, and America, where

they are being seen with increasing frequency.

Very tragically, child abuse does occur and deserves appropriate

punishment. However, it is equally tragic when a family, already

grieving over death or injury of their infant, finds a father or mother

unjustly accused, convicted, and imprisoned for murder or injury of the

infant, a murder of which he or she is innocent. In most instances

these families are not only devastated emotionally but ruined

financially so that their defense falls upon public defenders, which

very often seals their fate regardless of the merits of the case.

Personally I am a late-comer to this field following in the footsteps of

two pioneers, both Australians, Viera Scheibner, Ph.D. and Archivedes

Kalokerinos, a medical physician. Based on personal communication, Dr.

Scheibner has written reviews of 56 cases and testified in defense of

parents in some of them, all of whom she feels were innocent of charges

of SBS. Dr. Kalokerinos has worked in defense of 33 cases. In

virtually all of these cases there was a time-related onset of signs and

symptoms following vaccines. Other doctors have almost always dismissed

this association as coincidental, but this is not reasonable. By their

inherent nature, coincidental occurrences may be expected occasionally

but not with an incidence approaching 100 % as has been observed by Drs

Scheibner, Kalokerinos, and the relatively few in which I have been

involved.

If a large portion of accusations and convictions of SBS are the result

of misdiagnosis, as we believe, then we are witnessing a rapidly growing

reign of terror against the families of English-speaking countries.

As described in the medical literature, SBS commonly describes a

combination of subdural hematoma (brain hemorrhages), retinal

hemorrhages, and diffuse axonal injury (diffuse injury of nerve cells in

brain and/or spinal cord) as the triad of diagnostic criteria. In some,

the presence of rib or other fractures is also taken as a sign of child

abuse. (1-4) These basic concepts of SBS, which originated approximately

30 years ago, remain a basis for most SBS accusations and convictions

today in spite of newer scientific publications which promise to

revolutionize these older concepts. The following paper will address a

general review with comparison of older and newer concepts, showing that

many of the premises and claims on which SBS accusations and convictions

are being made are flawed and erroneous.

In order to maintain simplicity and avoid cumbersome length from

repetition, this paper includes several appendices to which the reader

will be referred when appropriate.

Premises and Claims Involved in SBS Accusations and Convictions:

In the joint statement on SBS from Canada, one finds the following

statements:

“Injuries that characterize Shaken Baby Syndrome are intracranial

haemorrhage (bleeding in and around the brain); retinal hemorrhage

(bleeding in the retina of the eye); and fractures of the ribs and at

the long ends of bones. Impact trauma may produce additional injuries

such as bruises, lacerations or other fractures. Shaken Baby Syndrome

is a condition that occurs when an infant or young child is SHAKEN

VIOLENTLY (emphasis ours)……..

“Shaken Baby Syndrome may be severely underestimated due to missed

diagnosis and underreporting……..

“Shaken Baby Syndrome can occur at any age but occurs most frequently in

infants less than one year of age…….

“The severity of the shaking force required to produce injury is such

that it cannot occur in any normal activity such as play, the motions of

daily living or a resuscitation attempt. The act of shaking that

results in injury to the child is so violent that untrained observers

would immediately recognize it as dangerous…..”

“Violent shaking has its most serious effect on the infant’s head,

causing it to whip backward and forward and to undergo rotational

forces. The shaking causes the shearing of blood vessels around the

brain, leading to a subdural haematoma (a haemorrhage around the

brain). The brain itself may be injured as it smashes against the skull

during shaking. Nerve cells in the shaken brain may be damaged or

destroyed.”

Rebuttals:

Five of the above-statements will be quoted below and used as examples

of common claims regarding the Shaken Baby Syndrome, to be followed by

rebuttals:

Claim 1: “Shaken Baby Syndrome (SBS) is a condition that occurs when an

infant or young child is shaken violently.”…… “It cannot occur in any

normal activity such as play, the motions of daily living, or a

resuscitation attempt.” (In the courts today it is becoming common if

not universal to accept the findings of retinal hemorrhages and subdural

bleeding as diagnostic of SBS and child abuse if found in the absence of

known accidental cause or illness).

Rebuttal: In an article by Jennian F Geddes, a neuropathologist at

Royal London Hospital, and colleagues, Geddes’s team studied the brains

of 53 children suspected of dying from deliberate injury. (5) Of the 53

children, 37 were less than a year old.

In the past, brain damage in such circumstances has been blamed on the

brain banging against the skull as a baby is violently shaken or

struck. It has been thought that this direct assault causes a

characteristic kind of damage to the axons of nerves known as diffuse

axonal injury (DAI). However, the researchers found evidence of DAI in

only two of the 37 babies. Instead they found that three-quarters of

the 37 babies had died because they stopped breathing as a result of

previously unseen and undescribed pathology that was focused on the

cranio-cervical junction, the point where the brain meets the spinal

cord, where a (non-violent) rocking motion can damage the vital part of

the spinal cord that controls breathing. When babies stop breathing as

a result of this injury, subsequent lack of oxygen causes the brain to

swell dramatically, which in turn causes hemorrhagic complications and

brain damage formerly attributed to violent shaking or blows.

The cranio-cervical junction is uniquely vulnerable in very young

babies, the authors explained, because their neck muscles are weak and

their heads relatively large and heavy.

The researchers found subdural hemorrhages in 72% of the 53 cases,

although most were too superficial to cause death. Also, retinal

hemorrhages were found in 71% of the 38 cases in which eyes were

examined, but the authors felt that these resulted from a lack of oxygen

to the brain (and the brain edema or swelling) rather than trauma.

In a news interview about her study, Geddes said that such injuries

could not happen just by bouncing a child on your knee or in normal

every day interactions between mother and child.

“They would have to involve vigorous unsupported movement of the head.”

She believes most people would realize that this would be dangerous,

“but you could imagine scenarios that might produce the damage without

it being deliberately inflicted,” Geddes stated. (6)

Also commenting on these findings, Binns, a criminal defense

solicitor with Victor Lissack & Roscoe of London, stated:

“Unless it is certain that injuries were caused by gross injuries or

worse, the judge will direct the jury to acquit. On the basis of these

findings it is impossible to imagine a prosecution succeeding in

anything but the clearest cases.” (6)

Pursuing the issue of the retinal hemorrhages, experience has shown that

some courts hold retinal hemorrhages alone as diagnostic of SBS, in the

absence of any other finding usually associated with the SBS diagnosis.

This is very difficult to understand. In none of the original articles

on SBS (1-4) was it stated or inferred that child abuse could be

diagnosed on basis of retinal hemorrhages alone. Plunkett, M.D.

pointed out this fallacy in the American Journal of Forensic Medicine

and Pathology in which he says:

“I do not understand the ‘retinal hemorrhage’ litmus test for shaken

infant. No one knows what causes retinal hemorrhage, although it is

highly correlated with rotational deceleration injury/subdural

hemorrhage in children, but retinal hemorrhage indistinguishable from

that found in rotational deceleration may be found in association with

ruptured vascular malformations, arachnoid cysts, and CNS (central

nervous system) infections.” (7)

There are other causes of retinal hemorrhages. In the text, Ocular

Differential Diagnosis, by Frederick Hampton Roy, M.D., increased

papilledema and increased intracranial pressure (from any cause) are

listed as possible causes of retinal hemorrhages, as well as the DPT,

polio, and MMR vaccines. (8) Retinal hemorrhages have been caused by

occlusion of the central retinal vein following a hepatitis B vaccine,

(9) and childhood resuscitation following events other than trauma.

(10-12)

Claim 2: “Shaken Baby Syndrome may be severely underestimated due to

missed diagnosis and underreporting.”

Rebuttal: In an article entitled “The Mistaken Diagnosis of Child

Abuse,” Kirschner and Stein made the following comments:

“The suspected diagnosis of child abuse may prove to be unfounded.

Reports in the literature have focused on unusual diseases and folk

medicine practices that may mimic abuse. We report ten cases where

allegations of abuse were lodged against parents because the treating

physicians in the emergency room mistook life-threatening illness or

postmortem artifacts for inflicted injury…..Although the histories

related by the parents were in all cases truthful and consistent with

the results of physical examinations of the child, the involved

physicians failed to make a correct diagnosis. Not only a lack of

experience with severe childhood illness and death but also an attitude

of suspicion and/or hostility probably contributed to these

misdiagnoses.” (13)

Along a similar vein, in a letter to the British Medical Journal,

English and Sutliff expressed their concerns about injudicious

questioning of parents by emergency room doctors when accidentally

injured children are brought in for care. They state:

“Many parents are insecure and uncertain anyway, especially those with

known predisposing factors in their case histories, such as being young,

having had children in special care units, multiple births, and abnormal

children. While the doctor’s primary aim is rightly to protect the

child from non-accidental injury it must be remembered that this is

achieved only by giving insecure families more support, and that the

alienation achieved by what is perceived as a witch hunt is strongly

counterproductive. Arguably, the deterioration in relations between

parents and health service personnel we have observed may actually lead

to more rather than less non-accidental injury.” (14)

Claim 3: “Shaken Baby Syndrome can occur at any age but occurs most

frequently in infants less than one year of age…..”

Answer: This statement is entirely correct. The great majority of

cases where parents are accused of SBS occur in infants below one year

age, most during the first six months of life. It is included here as

an introduction into a highly pertinent survey in this controversial

area.

This survey concerns an unpublished series of 25 cases involving

accusations or convictions for the SBS, largely collected by attorney

and jury counselor Toni Blake of San Diego, California (personal

communication 2000), which have the following features: 1) All occurred

in fragile infants born from complicated pregnancies. Problems included

prematurity, low birth weights, drug/alcohol problems, diabetic mothers,

or other maternal complications. 2) All infants were 6 months of age or

younger. 3) Onset of signs and symptoms occurred at about 2, 4, or 6

months age, within 12 days of vaccines. 4) All infants had subdural

hematomas. 5) Some had multiple fractures.

It is my understanding that this series is now much larger than the

original 25 cases and will in due time be made public. When this does

occur, it may prove to be of invaluable aid for embattled parents and

caretakers accused and/or convicted of SBS.

Claim 4: “Violent shaking has its most serious effect on the infant’s

head, causing it to whip backward and forward and to undergo rotational

forces. The shaking causes the shearing of blood vessels around the

brain, leading to a subdural haemotoma. The brain itself may be injured

as it smashes against the skull during shaking…..”

Rebuttal: It is true that violent trauma, either accidental or

non-accidental, can result in the pathologic changes described above.

However, the study of Dr. Jennian Geddes and colleagues previously

reviewed showed that, in a large majority of babies examined, death had

come about by an entirely different mechanism in which violent trauma

played no role. Also, as will be reviewed below, there are valid

grounds for believing that, in many of these cases, the brain edema

(swelling) with inflammation and hemorrhages may be the consequence of

vaccine reactions.

Claim 5: “Injuries that characterize the Shaken Baby Syndrome

are…..fractures of the ribs and ends of the long bones.” (In courts the

presence of fractures are generally accepted as pathognomonic, or

diagnostic of child abuse, in the absence of known accidental trauma.

This simplistic view lacks an acknowledgement, or even an awareness,

that there are a number of metabolic causes predisposing to spontaneous

fractures or to fractures from minimal trauma during infancy. Infants

born from problem pregnancies, as in the previously mentioned series of

attorney Toni Blake, are especially prone to such bone disorders. Some

of these will be outlined in the following):

Rebuttal: In instances where rib fractures of unknown cause are found

in infants, prosecutors often use the fractures as evidence of child

abuse. In this regard there are two situations in which spontaneous

fractures are prone to take place: temporary brittle bone disease

(TBBD) and scurvy, both of which are characterized by imperfect

connective tissue formation in fetal or infant skeletal tissue. In 26

infants with multiple fractures that fit the criteria of TBBD, (15-16)

there was a striking association between TBBD and decreased fetal

movement during pregnancy, which might occur in extreme prematurity,

multiple birth pregnancies, and chronic oligohydramnios (deficiency of

amniotic fluid) as a result of inadequate uterine space for fetal

movement.

Vitamin C deficiency may contribute to inadequate connective tissue

formation in the bones before birth, making them susceptible to

green-stick fractures and/or metaphyseal plate (costochondral junction)

slippages in utero or during the mechanical stresses of childbirth. Dr.

A Kalokerinos quoted from an older text dealing with scurvy that states:

“Scurvy disrupts these areas, the bone breaks down, and the ribs may

over-ride, forming in typical cases ‘beads.’ Then the healing commences

with new bone formation looking just like true healing fractures.

Furthermore, not all the ribs will be involved in this process, and the

changes will not all occur at the same time – giving the appearance of

multiple fractures of different ages.” (17)

A study of children at the Royal Children’s Hospital, ,

Australia has cast doubt on the acceptance of multiple metaphyseal plate

fractures as definite roentgenologic (X-ray) evidence of battering.

This type of fracture occurs in scurvy without undue trauma to the

child. (18)

Vaccines, Scurvy, and Hemorrhagic Diatheses:

Physicians and the lay-public alike generally think of scurvy as an

historical disease of the days of wooden sailing ships, which was

eliminated by the introduction of limes or other citrus fruit into the

diet. However, in a generation of young people and their families

increasingly turning to commercially processed “fast foods” as a major

part of their diets, subtle forms of scurvy may be returning, and being

subtle or “sub-clinical,” it is seldom recognized for its true nature.

As indicated by the following story, it is not only possible but

probable that vaccines may in some instances be escalating scurvy from a

smoldering to a fulminating phase, which is then misinterpreted as

Shaken Baby Syndrome:

In the 1970s Dr. Archivedes Kalokerinos, than stationed as a medical

physician among the Australian aborigines, was trouble by a very high

child mortality rate, in some areas approaching 50%. Dr. Kalokerinos

recognized signs of scurvy among the children, whose diets were very

poor. Observing that the children frequently died following

immunizations, especially if they had colds, he recognized that there

might have been a connection between vitamin C deficiency and the

vaccines. With improved nutrition, oral vitamin C supplementation,

injectable vitamin C during acute crises, and avoiding immunizations

during minor illnesses, infant mortality was virtually abolished. (19)

As a result of this work he was awarded the Australian Medal of Merit in

1978.

One of the primary roles of vitamin C in the body being that of

producing and maintaining connective tissue, Dr. Kalokerinos

hypothesized that with minor viral infections further depleting an

already marginal store of vitamin C, the administration of

endotoxin-bearing vaccines would sweep away the residual traces of

vitamin C provoking fulminating scurvy with hemorrhagic complications

from the of weakening of blood vessels.

Childhood Vaccines and Shaken Baby Syndrome:

General Background: Basic Science Deficiencies in Vaccine Testing:

As a result of deficiencies in original pre-licensing safety testing of

current vaccines, large numbers of vaccine reactions may be taking place

unrecognized, especially reactions of a delayed nature. (See appendix 2)

As a general statement, scientific evidence does not support the safety

of immunizations in that safety studies on vaccinations are limited to

short periods only: several days to several weeks. There are no

long-term (months or years) safety studies on any childhood vaccine in

use today. In addition, there are very few before-and-after published

studies on the effects of vaccines on immune parameters and brain

function of babies, studies which are indispensable in formation of a

basic science for the vaccines. Inadequate consideration has been given

to the additive or synergistic adverse effects of multiple simultaneous

vaccines, although in cases of toxic chemicals, two chemicals together

may be 10 times more toxic than either separately, or 3 chemicals 100

times more toxic. (20-22)

Two examples of before-and-after studies from older medical literature

will be cited as examples of these deficiencies. In 1955 AL Low of

Chicago published a study in which he did encephalograms (EEGs) on 83

children before and after pertussis immunization. (23) In two of the

children he found that the EEGs turned abnormal following the

immunizations without other signs or symptoms of abnormal reactions. In

his report he commented,

“This study suggests that mild but possibly significant (emphasis mine)

cerebral reactions may occur in addition to the reported very severe

neurological changes.”

Comment: During a time when neurobehavioral problems have become

epidemic among American children, this test suggest that unrecognized

brain injury from vaccines may be far more frequent than officially

recognized. One would think that a preliminary study of this nature

would have been repeated, but a careful search of the literature has

disclosed only one other similar study, one from Japan in which it was

found that 61 children with epilepsy or a history of febrile seizures

showed significant increases in “epileptic spikes” on EEGs following

DTP, DT, or BCG vaccines. (24)

The second example involves the testing of T-lymphocyte subpopulations

(white blood cells which help to govern the immune system) in eleven

healthy adults before and after routine tetanus immunizations. The

results showed a significant though temporary drop in T-helper

lymphocytes. Special concern rests in the fact that in 4 of the

subjects the T-helper cells dropped to levels found in active AIDS

patients. (25)

Comment: If this was the result of a single vaccine in healthy adults,

it is sobering to think of the consequences of a series of multiple

vaccines given to infants with their immature and vulnerable immune

systems.

With a poverty of basic science in current childhood vaccines, as

indicated by these two studies which have never had adequate follow up,

it is probable that many vaccine reactions are taking place unrecognized

as to their true nature. Signs and symptoms mimicking the Shaken Baby

Syndrome may be among these.

DTaP/DTP Vaccines and Shaken Baby Syndrome:

In medical research it is standard procedure to develop an animal model

of a disease for experimentation before proceeding into human studies.

In the case of Shaken Baby Syndrome, these animal models already exist

in publications involving pertussis endotoxin, studies showing reactions

to pertussis which match each and every feature of brain injuries now

represented in courts by prosecutors as proof of the Shaken Baby

Syndrome.

Studies by Iwasa stressed the finding of brain edema as a feature of

pertussis-induced encephalopathy. (26) It is of interest to point out

that there are anecdotal human reports of infants which developed

increased intracranial pressure with bulging fontanelles following DTP

immunizations, which tend to support these animal findings. (27-29) In

addition, in 1972 Galazka reviewed a series of autopsies on children

whose deaths followed the pertussis vaccine. Although limited in

number, findings included brain edema, hyperemia, and soft meninges.

(30) As shown in the study of J Geddes as well as other sources

previously quoted, brain edema in and of itself may result in both

retinal and brain hemorrhages.

Munoz in turn conducted mice studies with pertussigen, an endotoxin

derivative of the pertussis bacteria, in which he found (inflammatory)

infiltrates of lymphocytes surrounding blood vessels in the brain and

spinal cord, findings compatible with an autoimmune encephalitis. (31)

It is noteworthy that vaccines such as pertussis have been used to

induce allergic encephalomyelitis in laboratory animals since 1973, (32)

characterized by brain swelling and hemorrhages similar to that caused

by mechanical injuries.

Allergic Sensitization by Vaccines:

Among the components and combinations of vaccines routinely given to

infants during the first six months of life, the period during which

most complications attributed to SBS take place, those which have been

reported as causing hypersensitivity reactions include pertussis,

(33-34), Hemophilus influenza (Hib), (35) aluminum, (36) the mercury

adjunct thimerosal, (37) and tetanus (38). Depending on the agent,

reactions may be either of an anaphylactic and/or autoimmune nature.

The Controversy of the Latent Period:

According to current guidelines of the Congressional Childhood Vaccine

Injury Act of 1986, the onset of signs and symptoms of encephalitis must

take place within certain time limits following vaccination in order to

qualify for compensation under this act. The current time limit for the

DTP/DTaP vaccines is 3 days, any event taking place beyond this time

limit not being accepted as vaccine-related.

In clinical practice as well as the courts, this time limit has become

accepted as the medical-legal standard. However, there are strong

grounds for believing that this time limit represents human artifact and

not the realities of what is taking place with vaccine reactions. This

subject is too lengthy to include here but is reviewed in Appendix (2).

Hepatitis B Vaccine and the Shaken Baby Sydrome:

In 1994 a special committee of the National Academy of Sciences

(Institute of Medicine) published a comprehensive review of the safety

of the hepatitis B vaccine. When the committee, which carried the

responsibility for determining the safety of vaccines by Congressional

mandate, investigated five possible and plausible adverse effects, they

were unable to come to conclusions for four of them because they found

that relevant safety research had not been done. Furthermore, they

found that serious “gaps and limitations” exist in both the knowledge

and infrastructure (basic science) needed to study vaccine adverse

events. Among the 76 types of vaccine adverse events reviewed by the

IOM, the basic scientific evidence was inadequate to assess definitive

vaccine causality for 50 (66%). The IOM also noted that,

“If research…(is) not improved, future reviews of vaccine safety will be

similarly handicapped.” (39)

A scattering of reports suggest that the hepatitis B vaccine may play a

major role, as yet largely unrecognized, in hemorrhagic complications

from vaccines. One especially poignant case involves a mother whose

quadruplets each suffered subdural hemorrhages or bloody spinal fluid

following hepatitis B vaccines. The mother of these children has been

sentenced to 172.5 years in prison.

Among the 109 references provided in Appendix 3 involving reports of

adverse reactions from hepatitis B vaccine, various forms of vasculitis

(inflammation of blood vessels) appear with special frequency along with

a variety of autoimmune neurologic, rheumatoid disorders, and

thrombocytopenia (reduction in blood platelets). Inflammation of blood

vessels, in turn, implies greater fragility and friability of blood

vessels with greater tendency for hemorrhages. In a report of 18 deaths

of neonates following the hepatitis B vaccine by the Vaccine Adverse

Event Reporting System, 1991-1998, hemorrhagic phenomena were common,

including two patients with cerebral hemorrhages, four with pulmonary

bleeding, one with bloody diarrhea, and several with blood in the upper

airway passages. (40) A report in Postgraduate Medicine on acute

hemorrhagic encephalitis cites vaccines as one of the possible causes.

(41) Hypersensitivity vasculitis with swelling and bruising, diagnosed

by biopsy, has been mistaken for child abuse. (42)

Thimerosal; the Mercury Issue:

Prior to 1999 most brands of DTP/DTaP, hepatitis B, and Hib vaccines,

(all of which have been given routinely at ages 2, 4, and 6 months age

for a number of years) contained ethyl mercury in the form of

thimerosal, added to the vaccines as a preservative and an adjuvant to

increase the potency of the vaccine. If one adds 25 micrograms mercury

in a DTP/DTaP vaccine, 12.5 micrograms in hepatitis B, and 25 micrograms

in the Hib vaccine (Hemophilus influenza), it is theoretically possible

that some infants were receiving over 50 or even a 100 times more than

the allowable safe dose according to current U.S. Environmental

Protection Agency (EPA), which limits safe exposure to a maximum of 0.1

micrograms mercury per kilogram of weight per day. (43)

Since 1999 thimerosal has been removed from some vaccines but remains in

others. Tables of vaccines with and with thimerosal are provided for

the U.S. Center for Disease Control. (44)

For over 200 years mercury has been known as a potent neural (brain)

toxin and one of the most toxic of the heavy metals. A possible

mechanism for this toxicity has been disclosed in a recent animal study

in which mercury vapor exposures resulted in retrograde degeneration of

neuronal (brain) membranes, producing molecular lesions similar to those

seen in the brains of patients dying with Alzheimer’s disease. (45)

Since August, 1999 a series of Congressional hearings have been taking

place addressing issues of vaccine safety, headed by Congressman Dan

Burton, Chairman of the U.S. House Government Reform Committee. More

recent hearings have focused in part on the thimerosal (mercury) content

of vaccines. Apparently as an off-shoot of these hearings, the

Institute of Medicine, a scientific board usually assigned to evaluate

controversial issues, issued a report on October 1, 2001 entitled,

“Thimerosal-Containing Vaccines and Neurodevelopmental Outcomes.” The

IOM report states:

Page 10: “The committee concludes that although the hypothesis that

exposure to thimerosal-containing vaccines could be associated with

neurodevelopmental disorders is not established and rests on indirect

and incomplete information, primarily from analogies with methylmercury

and levels of maximum mercury exposure from vaccines given in children,

the hypothesis is biologically plausible.” (Emphasis mine)…….Page 11:

”The committee recommends the use of thimerosal-free DTaP, Hib,

hepatitis B vaccines in the United States, despite the fact that there

might be remaining supplies of thimerosal-containing vaccines

available.”

The IOM is now on record stating that it is “biologically plausible”

that thimerosal-containing vaccines may be causally related to the

current increases in the childhood neurodevelopemental problems such as

autism, ADHD, speech delays, and other conditions. In my opinion, this

list should include vaccine reactions that are mistakenly diagnosed as

Shaken Baby Syndrome.

Conclusion:

As a conclusion I would like to draw a hypothetical composite picture of

a number of babies diagnosed with the Shaken Baby Syndrome, based on

personal experience as well as the experiences of others with which I am

familiar:

Let us assume that a baby was born prematurely in early 1999, the

product of a complicated pregnancy with maternal diabetes, recurrent

urinary tract infections, and constant nausea which resulted in limited

weight gain during the pregnancy. Diminished fetal movements were noted

by the mother during the latter part of the pregnancy. Labor was

induced at 36 weeks because of oligohydramnios (deficiency in amniotic

fluid). Birth weight was 5 pounds.

The neonatal period was complicated by prolonged jaundice, feeding

problems, nasal congestion, colic, fussiness, and constipation. Just

prior to the routine two-month pediatric visit the baby acquired a head

cold, although there was no fever. At the two-month visit routine

childhood vaccines were administered which included the DTaP, Hepatitis

B, Hemophilus influenza (Hib), and injectable polio. (In 1999 the

hepatitis B vaccine would have contained 12.5 micrograms of thimerosal

(ethyl mercury), and most brands of DTaP would have held 25 micrograms,

most brands Hib 25 micrograms) Calculated on basis of 0.1 micrograms

per day per kilogram body weight of the infant, the 62.5 micrograms of

ethyl mercury would have been over 100 times the allowable amount of

mercury in a given day according to U.S. Environmental Protection Agency

standards for an average weight baby, even more so for a low birth

weight baby born prematurely.

Let us assume further that the baby developed a high fever within hours

of receiving the vaccine along with high-pitched inconsolable crying, at

times accompanied by an arching of the baby’s back. The fever and

constant crying did subside after about two days, after which the baby

alternated between somnolence and fretfulness. The parents traded off

nights with the baby and became exhausted. One of these nights, twelve

days following the vaccines, the mother was pacing the floor and rocking

the baby. She was nearly stupefied with fatigue. She later recalled

that, in an unguarded moment, she may have left the head unguarded and

unsupported while rocking the baby so that the head may have flopped

back and forth several times. Several hours later in checking on the

baby in its crib, the parents found that the baby was not breathing.

They attempted artificial resuscitation, called 911, and the child was

rushed to the hospital in an ambulance. Resuscitation was successful in

the hospital emergency room and the baby admitted to a critical care

unit. Initial examinations and tests revealed retinal and brain

hemorrhages as well as evidence of two old rib fractures. Life-support

measures were removed three days following hospital admission when it

was determined that the baby was brain dead.

Autopsy confirmed the findings of retinal/brain hemorrhages and rib

fractures along with the finding of massive cerebral edema (brain

swelling).

Following the baby’s death the mother remained numb with fatigue and

grief. While in this state a group of people approached her and

informed her that the autopsy findings were suggestive of the Shaken

Baby Syndrome. Since she was the last person to handle the baby, she

was to be held in custody on suspicion of murdering her baby.

In my opinion, criminal proceedings in such cases, where there is no

conclusive evidence or history of child abuse, perform a gross

miscarriage of justice. If there must be criminal proceedings, as some

insist, I for one believe the charges should be directed elsewhere and

not on the heads of the parents (in this case the hypothetical mother).

Perhaps the only final answer to this dilemma will come when parents are

granted freedom of choice to accept or reject vaccines for their

children based on informed consent. This will give parents the power to

compel adequate vaccine safety testing and surveillance based on the

power of the free market, the ultimate system of checks and balances.

Appendices:

(1) Buttram HE, Shaken Baby Syndrome or vaccine-induced encephalitis?,

Medical Sentinel, Fall, 2001, 6(3): 83-89.

(2) “The Controversy of the Latent Period,” (unpublished article).

(3) List of 109 publications reporting on Hepatitis B vaccine

reactions.

References:

(1) Weston IT, The pathology of child abuse, in: Heifer RE, Kempe CH,

editors, The Battered Child, University of Chicago Press, 1968: 77-100.

(2) Guthkelch AN, Infantile subdural hematoma and its relationship to

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