“Through the years, I had noticed we had a lot of female perpetrators, so I decided to see if there were any differences, and there were,” said Esernio-Jenssen, a child abuse pediatrician who conducted her research while medical director of a child protection consultation team at a New York children’s hospital. “Victims of males had more significant injuries — all six deaths were from male perpetrators. Another big difference is that males tended to confess and females didn’t.”
Although past studies have traditionally linked more cases of abusive head trauma to men, half of the patients in Esernio-Jenssen’s study were abused by women.
“Mothers for centuries, probably, have been picking up and shaking infants,” she said. “Although males are often more represented (in criminal cases), when you take anonymous phone calls, mothers say they shake their kids to get them to stop crying. If you do shake a baby hard enough, they do go to sleep; they become unconscious.”
Although some parents might worry that a child may experience abusive head trauma after being playfully tossed in the air or falling from a bed, the force needed to generate these injuries is significantly more violent, Esernio-Jenssen says.
The head trauma inflicted when a baby is violently shaken or suffers a severe blow is actually similar to what would happen if a child were riding in a car that rolled over or was in a major collision. Injuries can include bleeding and swelling in the brain and retinal hemorrhages. Abusive head trauma can also cause the heart or breathing to stop and can put a child in a coma. Lasting neurological damage can occur, if the child survives.
“This is not playing, bouncing the baby on your knee or even tossing him up in the air. This is violent, severe shaking,” she said.
The children in the study ranged from 1 month old to almost 3 years of age. Almost all the children had bleeding in their brain and retinal hemorrhages. They were more likely to suffer from cardiopulmonary arrest, require care from neurosurgeons and have a worse outcome if their abusers were male.
Women were least likely to confess — only three of 17 did, compared with 15 of 17 men who confessed — and least likely to be prosecuted. The women were also older on average than the men. The median age of female perpetrators was 34, seven years older than the median age of men.
During their confessions, 18 perpetrators admitted specifically to shaking the children, linking the victims’ abusive head trauma to shaking and not a blow to the head or other injury, Esernio-Jenssen said.
“This adds to the literature,” she said. “People do confess to shaking, alone. And kids do die from shaking.”
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