A few years ago, Pam Johann was a first-time mother with a beautiful baby boy-who cried for hours at a time. She was frightened, frustrated, at her wits' end. One day she decided to let Peter cry while she did some housework. She switched on the vacuum cleaner and to her amazement, Peter soon stopped his wailing. He was comforted by the constant, steady noise.

It's such a helpless feeling when you've tried everything-rocking, singing, walking-but the baby just keeps crying! You feel frustrated and powerless, guilty and inept.

That's a dangerous moment-a moment when some desperate parents step over the line and hurt their babies (see below: Never shake the baby) That's why it's so important for parents to prepare themselves with information on things they can do and places they can turn for help. Baby experts offer these pointers:

• Remember that it's normal for babies to cry. A baby's crying is not a reflection of your parenting skills. A baby's cry is an attempt to communicate. In his book, Child Abuse Medical Diagnosis and Management, Dr. Robert Reece estimates that a normal infant cries for two to three hours each day and "20 to 30 percent of infants exceed that amount of time, sometimes substantially."
  
  
• Make sure your baby's basic needs have been met. You have probably thought to check your baby's diaper and to offer food. It is also possible that he has been overfed. If your child seems ill or in pain, call your pediatrician or advice nurse. Did anything stressful or unusual happen today? He may have been overstimulated by a big outing or a number of visitors.
  
  
• Try something different. Try gently stroking her arms, legs, or back, says Zero to Three: The National Center for Infants, Toddlers and Families. Swaddling her snugly in a blanket offers comfort and warmth. Try walking with the baby in your arms, going outside, or taking her for a ride in the car (with a properly installed car seat). Offer a pacifier. Expose your child to continuous "white noise" (like the sound of rain or a hair dryer). Zero to Three also says some babies may be overstimulated when parents look at them and talk to them. Trying singing without eye contact for a while; then switch to gazing without speaking.
  
  
• Take a break. Anita Moran, Director of T.A.L.K. (Telephone Assistance in Living with Kids) Line Volunteers in San Francisco, recommends giving yourself a break when you are feeling overwhelmed. Once you've met all of your baby's basic needs, it's OK to let him cry for a while. Put him in a safe place and check on him every five minutes.
  
  
• Ask for help. Call a friend or family member. Or call a local or national hot line (see "Resources." They offer confidential emergency counseling and referrals to local services.

NEVER shake the baby!

Crying becomes particularly problematic during the six-week to four-month age bracket," says child-abuse expert Robert Reece. This age period "coincides with the peak incidence of Shaken Baby Syndrome." Experts say that endless crying is often what pushes adults to shake babies.

Why is it dangerous to shake babies? Only severe shaking causes injuries-but those injuries can be serious or even fatal. That's because the baby's brain and blood vessels are very fragile. They're also more likely to be injured because the baby's head is so large compared to the rest of the body, and the neck muscles are weak. Shaking can cause eye injuries or brain damage, sometimes even death.

Is it dangerous to bounce a baby on your knee? No! Bouncing and friendly rough play don't hurt babies. The shaking has to be very severe to cause damage.

Does it help to educate parents? Yes! Hospitals in upstate New York and Utah have adopted a prevention program that they say has cut down on Shaken Baby Syndrome. In the program, developed in Children's Hospital in Buffalo, New York, new mothers watch a video explaining the dangers of shaking babies and sign a statement that they understand the risks. After the program started, cases of Shaken Baby Syndrome dropped dramatically in the surrounding counties.

Who can help prevent Shaken Baby Syndrome?

• Parents can get information on ways to soothe a crying baby and places they can go for help if they feel overwhelmed.
  
  
• Hospitals where babies are born can make sure new parents understand the dangers of shaking babies.
  
  
• Pediatricians can talk with parents about their level of stress and what they do when the baby won't stop crying. They can explain the risks of shaking babies, offer suggestions, and refer parents to community resources for support.
  
  
• Child care providers can learn about community resources and hot lines and educate parents through posters, workshops, or informal conversation.

A healthy baby's cries

What They Can Mean

• I'm hungry.
• I'm tired.
• I'm overstimulated.
• I'm uncomfortable. 
• I need a cuddle or a pat.

What They Don't Mean

• I'm angry at you.
• I want to get back at you.
• I want to disrupt your life.
• I feel abandoned.
• I'd rather be someone else's baby!

Excerpted from Secrets of the Baby Whisperer: How to Calm, Connect, and Communicate with Your Baby by Tracy Hogg.

Resources

National hot lines

• Child Help USA: National Child Abuse Hotline, 1-800-4-A-CHILD
  
  
• National Committee to Prevent Child Abuse, 1-800-CHILDREN

Local resources

• Child abuse prevention councils. Most local areas have one. To find the one nearest you, contact Prevent Child Abuse California, 916-498-8481
  
  
• Parent support organizations and parent hot lines. Get information on local resources from the local child abuse prevention council or child care resource and referral organization-for the R&R nearest you, call 800-543-7793. Or look in the yellow pages under "parent" or "social services."

Products

• A seven-minute video, Crying: What Can I Do? and other materials in English and Spanish, are available from Shaken Baby Syndrome Prevention Plus, 1-800-858-5222, www.sbsplus.com
  
  
• Video, Handle with Care, Fresno Child Abuse Prevention Council, 559-226-2651
  
  
• Video, Portrait of Promise, Midwest Children's Resource Center, 651-220-6703
  
  
• Compact Disk, For Crying Out Loud (Pam Johann's compilation of white noise-vacuum cleaners, hair dryers, rain), Perpetual Cow Productions, 510-841-1166; www.perpetualcow.com

Added 2005: Extra resources from the Children’s Advocate bulletin

• Pointers for Parents, from Zero to Three, is a set of camera-ready articles on child development issues affecting infants and toddlers. Topics include healthy child development, play to learn, physical activity, and early literacy. Online at http://www.zerotothree.org/handouts
  
  
• Home Visitation in 2005: Outcomes for Children and Parents, from Invest in Kids Working Group, looks at the economic returns of home visiting programs for young children—particularly when combined with early childhood education programs. Online at http://www.ced.org/
  
  
• Policy Recommendations for At-Risk Infants and Toddlers, from Zero to Three, finds that 21% of children in foster care were admitted before their first birthday. Recommends that foster care agencies minimize multiple foster care placements, ensure developmentally appropriate visitation, prevent child abuse and neglect, and ensure access to health care, mental health care, quality child care, and supports for adoptive families and families seeking reunification. Online at http://www.zerotothree.org/policy/factsheets/cw.pdf

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