"The pathologist challenging shaken baby syndrome"
Pediatric pathologist, Dr. Irene Scheimberg, talks to journalist Sue Armstrong:

(Interview) Sue: Have you any clues as to what the mechanism causing "shaken baby" symptoms might be?

"I'm exploring all sorts of theories. My colleague Marta Cohen from Sheffield Children's Hospital and I have just published a paper with observations of our autopsy work on fetuses and babies over the last couple of years. We selected 55 cases - 25 late third trimester fetuses who died shortly before delivery and 30 newborns - who had haemorrhage within the membrane that covers and separates the two halves of the brain, and compared this with the level of brain hypoxia, or oxygen deficiency. We knew that none of these cases could possibly be inflicted trauma. We found that all those with severe brain hypoxia and half of those with moderate brain hypoxia had SDH. This is the same type of SDH that some people describe as specifically indicative of shaken baby syndrome. A similar pattern of haemorrhages has been described in the retinas of newborn babies dying of natural causes. We think that in these cases the hemorrhaging is caused by the hypoxia.

My concern is that by relying on this famous triad of symptoms - brain hypoxia, SDH and retinal haemorrhages - to diagnose shaken baby syndrome, when there's no evidence of inflicted trauma, we may be sending to jail parents who lost their children through no fault of their own. As scientists it's our duty to be cautious when we see the triad, and to take each case on its merits. We owe it to the children and their families." --Dr. Scheimberg

The False Medical Claim That Clinical Signs Show Cause And Motive
Many doctors claim there is a difference in symptoms caused by abuse and accidental injury. This suggests the body expresses "accidental" and "on purpose" differently, as though there were clinical signs that can diagnose motive. Of course, if an infant is found with external signs of inflicted trauma like cigarette burns, cuts, bites, finger mark bruises, ligature marks, etc., then these are signs of abuse. However, these signs are rarely present in infants diagnosed with SBS. In fact, the original description specifically listed "no external signs of abuse", which is why shaking was assumed. Common signs of abuse make this a "battered" baby, not a shaken one. However, there are signs mistaken as abuse such as abnormal bruising, the appearance of burns, and other markings that have medical causes.

In spite of claims to the contrary, there are no clear clinical signs that differentiate between accidental and non-accidental injury. The physiology of the body responds the same to both without being able to tell motive, or mechanism of action. Was a head injury accidental or inflicted? That determination lies beyond the scope of a treating physician, although doctors continually cross the line between medicine and law and overstep their boundaries to do so in blaming caretakers. Factor undiagnosed medical causes into the mix and what gets cooked-up is calamity.

There are some clinical signs aside from the obvious mentioned above that may tell a story. Subdural hemorrhages do occur with differences. There are thin types and thick types. Thin types are usually associated with hypoxia--a lack of oxygen to the brain, for example, following an incident of "apnea" (most often associated with vaccine adverse events), heart incidents, drowning, or other causes that would interfere with the oxygen supply to the brain. Improper insertion of a breathing tube down an infant's throat might cause the same thing. But if there are injuries without medical causes, they do not tell how a thing happened or who did it.

Blunt force trauma to the head, accidental or non-accidental, would more likely result in the thick kind of subdural hematoma.

Most infants diagnosed with SBS have the thin type uncharacteristic of blunt force trauma.

Hemorrhages in the eyes are believed to take certain shapes in SBS infants. However, the same types of hemorrhage are found in vitamin C deficiency, which may occur in the form of chronic, subclinical scurvy in a developing fetus of any infant whose mother had a deficient diet during her pregnancy, health issues of her own or smoked, or after birth by feeding an infant baby formula (breast milk is loaded with vit. C), heated cow's milk, or some other inappropriate diet who experiences any unusual stress from infections or illness, vaccinations which act like infections, certain drugs or medications, or other stresses on a baby's fragile, immature immune system.

Whiplash-shaken infants in vehicle crashes almost never present with the symptoms associated with SBS even though the mechanism of action is the same. Neither has there ever been a reliably witnessed or documented case of shaking alone that produced these symptoms. On the other hand, there have been documented cases of shaking, such as those caught on "nanny-cams" where no injury has occurred.

"Confessions": False, Intentionally Misinterpreted,
Accounts Of Actions Unrelated To Abuse
Confessions are not reliable. People may gently shake a comatose or dead infant trying to "wake it up" and get blamed for the very condition they were responding to. Or caretakers trained in infant CPR may apply the "(gently) shake and shout procedure they were taught up until recently to determine if an infant is responsive before applying CPR, and again be accused of abuse for responding to a crisis already in progress. Or in the few cases where actual rough or violent shaking takes place when a caretaker "loses" it due to the most common stated cause of "inconsolable crying", that in itself may be a symptom of a life-threatening condition such as vaccine-induced encephalitis, and the baby's condition may not have anything to do with shaking. And then there are the ever-present plea bargains. When a defendant is threatened with 40 years to life in prison if they persist in claiming their innocence and going to trial, when conviction is assured based on symptoms alone, plea bargains are the way most people go, innocent or guilty. And because most end in plea bargains, and there is precious little evidence otherwise, SBS proponents use "plea bargains" as "proof" that SBS exists. Otherwise, there is little science to the SBS hypothesis of cause, and a growing body of evidence to dispute it, at least without impact to the head.

This is not to deny the fact that a person can shake an infant hard enough to kill it or do long-term injury. Of course a baby can be shaken to death. But the injury is to the neck and spine, not to the head. In SBS cases, signs of external trauma to the head are rarely seen, and no signs of neck injury are found. In fact, they are rarely even examined for neck injury, although this is the first place they would logically look for injury in a whiplash-shaken incident involving a vehicle crash without head impact.

SBS "evidence" is not based on scientific proof, but upon an unproven hypothesis that was embraced without proper peer review and testing to eliminate other causes. It relies on assumptions and social histories of supposed "shaking" incidents, although most shaking is assumed if the caretaker can't prove otherwise, or by questionable and usually tainted "confessions" which include shaking a baby who has become comatose to try to "wake it up", or the CPR procedure of "shake and shout" to determine if an infant is responsive before applying chest compressions and mouth resuscitation efforts. More frequently, plea bargains where the caretaker is threatened with anything from 20-to-life, or even death if they go to trial and plead innocent comprise the main body of "statistics" used as evidence in support of shaking, despite their lack of scientific validity. Emotion wins the day, overwhelming common sense and the need of in-depth medical and forensic investigation.

There is a growing international group of doctors, scientists--biomechanical engineers in particular--researchers, and other individuals and groups organizing against the SBS diagnosis. The days when an assumption of SBS based on symptoms alone led directly to a conviction, usually from plea bargains signed by terrified caretakers threatened with longer sentences if they dared go to trial is coming to an end. The careers of several forensic pathologists in Canada and England have ended due to shoddy or inefficient forensic evaluations of supposed SBS cases, and convictions are being legally re-examined in these countries. The U.S. is lagging far behind, but the times are changing, and American medicine is beginning to reflect or at least to react to the changes.

"Must-read" sites: 
http://www.wellwithin1.com/shakenbaby.htm
http://www.whale.to/vaccines/sbs1.html

When Dr. John Caffey, a specialist in the new field of radiology, published an article about long bone fractures in infants with chronic Subdural Hematomas in 1946 that became his later "Whiplash Shaken Infant" theory, he had been puzzling over the bodies of dead infants with no sign of external trauma. Autopsy and x-rays found fractures in long bones and bleeding in the head and sometimes behind the eyes--Subdural Hematomas (SH) and Retinal Hemorrhages (RH), which often occur together. A "must read" article on how "junk science" becomes "accepted medical theory" with the specific example of Caffey's invention of a hypothesis and how he pounded square pegs into round holes to make it fit: "FORENSIC SCIENCE AND THE SCIENTIFIC METHOD"

There was no bruising, no signs of abuse to explain the injuries. He suspected Barlow's disease (infantile scurvy), but this was usually only found in babies over 6-7 months old after exclusive feeding on baby formula lacking the enormous amount of vitamin C found in breast milk, and some of these infants were younger than that. He wasn't aware then that malnutrition can begin in the womb or that certain conditions accelerated vitamin deficiency besides just deficient baby formula, so Barlow's was listed as a "differential diagnosis" while he looked for another cause. The problem was, while he looked for a new cause, he didn't test to eliminate old causes, of which there were several possibilities.

Then doctor Caffey heard the story about a physically massive, mentally ill nurse who was held responsible for the death of several infants. She confessed that she had been driven to state of frustration over one infant who refused to take her bottle of formula and shook the baby, after which it died. What caused the lack of appetite was never questioned, on important omission considering that anorexia and swallowing difficulties are symptoms of scurvy. Instead, Caffey jumped on the idea of "shaking" as the cause of death, and without any supporting medical evidence other than her confession, believed he had found the explanation for a sudden rash of infant deaths being seen, and from then on believed and promoted the theory that "whiplash-shaking" was the cause, although he stopped short of blaming caretakers of intentional abuse in the beginning. His first article on the subject was "Multiple fractures in the long bones of infants suffering from subdural hematoma". After primate studies in 1968 proved that bleeding in the brain could be caused by mechanical shaking, he thought his hypothesis was "proven", ignoring the warning from the scientist that humans were likely incapable of producing the forces achieved in his mechanical shaking studies, which was proven to be prophetic advice a few years later, and that the injured primates had neck injuries in most cases.

The evolution of the "whiplash shaking" hypothesis is detailed in the book, "THE SHAKEN BABY SYNDROME: A Multidisciplinary Approach" by proponents of SBS, as follows: Page 15-17

The book discusses the theory considered at the time that scurvy was the cause of subdural hematoma due to a weakening of the tissues and tearing of veins in the head leading to Subdural Hematoma and bleeding behind and in the eyes rather than another belief attributing Subdural Hematoma exclusively to impact injuries in most cases, or swelling/inflammation. The problem with the book is that while head impact can cause SH and RH, scurvy (vitamin C deficiency) does cause bleeding in the brain and eyes and other parts of the body, and retinal hemorrhages are being found in many cases unrelated to abuse. Vitamin C deficiency also causes spontaneous fractures in the long bones and skull, fractures from normal handling, or the false appearance of healing fractures in different stages when hemorrhages on the skin of the bone calcify and look like healing fractures. It also causes abnormal bruising, inflammation, infections--particularly respiratory and purulent ear infections--lesions on the skin and in the mouth, and every other symptom attributed to SBS, or it's more recent incarnation, Shaken-Impact Baby Syndrome or the generic descriptions more frequently used now of "non-accidental injury" or something related to "inflicted head trauma". 

Strangely, even Caffey noted that breast-fed babies were rarely found in this group, but it was treated dismissively when a colleague pointed out that poor environments where malnutrition from lack of breast feeding might occur were also likely to be situations where abuse occurred.

In later years, changes in the demographics of "abuse" were seen as more fathers, boyfriends, babysitters, and day care providers were accused of shaking abuse. No one noted that if SBS babies were almost exclusively bottle-fed, that meant mothers were out of the home working or otherwise not around to nurse and that infants were now more frequently left in the care of others.

Before a medical hypothesis becomes an "accepted medical theory" it normally goes through a rigid scientific method which includes trying to disprove it, and if successful, moving on to another hypothesis, followed by a peer review process and a lot of testing and questioning, with supporting science provided. This is a much-needed process of checks and balances in the world of science. Caffey's whiplash-shaken concept by-passed this process, possibly because prosecutors, social services, and law enforcement liked the idea and ran with it, forcing doctors and scientists to follow suit. There may be other reasons for the support of medical authorities almost too incomprehensible and abhorrent to consider--that they don't want medical causes found that might impact on their livelihoods and reputations. The possibility of a vaccination connection alone, or the use of antibiotics, their advice not to give infants juice until after 4 months, and then apple juice instead of C-loaded orange juice and other medical connections are enough for a "call to arms" against any criticism of a theory they are quite content with, particularly if they might be charged with malpractice and criminal misdiagnosis for past cases.

Other symptoms found in Caffey's original 6 cases: "Caffey Revisited: A Commentary on the Origin of “Shaken Baby Syndrome” by Dr. C.A.B.Clemetson, MD

Case 1. A purulent discharge from the right ear began at age 5 months and persisted for 2 months; a convulsion due to subdural hemorrhage occurred at 7 months. Spontaneous fracture of the right radius occurred after nine days in the hospital.

Case 2. Convulsions began at age 1 month. At 7 months, the infant developed soft, spongy, bleeding gums typical of scurvy, and retinal petechiae indicative of increased capillary fragility. At age 8 months, he developed signs of subdural hematoma.

Case 3. Multiple fresh hemorrhages were present in both ocular fundi. Petechiae were also scattered on the abdominal wall, and a large ecchymoses was seen on the left side of the face.

Case 4. Radiographs showed evidence of epiphyseal separation at the proximal end of the right humerus, suggestive of scurvy.

Case 5. Subdural hematoma and bone fractures associated with otitis media were present; black-and-blue spots on the forehead and face could be interpreted as either traumatic or scorbutic.

Case 6. There was bilateral proptosis due to retrobulbar hemorrhages consistent with scurvy—akin to the unilateral proptosis seen in vitamin C-deficient 18th century sailors.

These symptoms are found in infantile scurvy which Caffey listed as a "differential diagnosis" but he failed to test for it in spite of it's likelihood. Other causes should have been examined and eliminated first, before making an assumption of "whiplash-shaken injury" based on the lack of external trauma signs.

Scurvy is seldom looked for or expected in this day and age, but new technology described in 2004 involving the examination of pericorneal vasculature for vitamin C levels provided evidence from a large study that most people (all in the study) are affected at some time by vitamin C deficiency.

"Other Causes" noted for their lack of inclusion: Vaccine injury, serum vitamin C deficiency (although scurvy is listed), blood histamine increase, endotoxin poisoning from vaccinations or "wild" infections, antihistamine, antibiotics. "Vaccine poisoning" is omitted but may underlie several disease conditions.

Are clinical guidelines for differential diagnosis testing that might prove innocence due to disease conditions or abnormalities simply being ignored?

In cases where gentle shaking is admitted, it usually consists of caretakers describing having gently shaken an unconscious infant to "wake it up" or as the procedure of "shake and shout" daycare providers, EMTs in training and other are taught to do to check for any sign of response before applying CPR, even to a newborn. That may be changing now with the rapid increase in babies claimed to be injured by "shaking," but it's been done for decades this way without harming the infant.

In the few cases where vigorous shaking is admitted, it nearly always has to do with desperation and extreme frustration caused by persistent "inconsolable crying" without considering that type of crying, particularly "inconsolable high-pitched crying" possibly mistaken for "colic" is very specific to several infection, septic or disease conditions--particularly within a 21 day period after a vaccination--which produce the same symptoms seen in assumed shaken or shaken/impact abuse cases, and that the conditions may have preceded the shaking.

The reasoning behind Caffey's theory and its modern day manifestations appears to be the kind of circular non-science as follows: The presence of symptoms such as retinal hemorrhages and subdural hematoma prove that a baby was shaken. How do we know it was shaken? --because it has retinal hemorrhages and subdural hematoma. (Circular Reasoning Fallacy)

Are these symptoms "pathognomic" (occurring only in these circumstances) of Shaken/Impact Baby Syndrome? No. (check symptoms in the side menu). In short, retinal hemorrhages, subdural hematoma and the other symptoms associated with SBS have other causes singly and as a group.

Are the "differential diagnosis" (other causes) usually listed in most cited, peer-reviewed medical literature on other topics ever tested for in suspected abuse cases? Almost never. The following conditions can cause a hemorrhagic condition due to "capillary fragility" resulting in abnormal bruising and hemorrhaging and bone abnormalities including spontaneous fractures, fractures caused by normal handling or minor trauma, and the appearance of healing fractures at different stages due to callus formation over subperiosteal (the skin covering on bones) hemorrhages which are indistinguishable from healing fractures on x-rays or even at autopsy unless special tests are done.

An exception: a foreign medical journal account of a suspected abuse case in which differential diagnosis was properly tested for before the parents were arrested and the child was found to have scurvy/rickets rather than having been injured through abuse. A broken leg resulted from a short fall that shouldn't have caused any injury whatsoever. (link will be added later)

Do accidental cases of shaken/impact injuries of equal force produce the same symptoms? No, according to "experts" who claim non-accidental causes do so exclusively ...without regard for the known laws of physics, making SBS cases unique--an apparent scientific oddity.

Caffey's unproven theory first put forth in the 1946 was built on the shaky and unscientific basis of assumption. In later years when he more directly claimed infants were being shaken violently, he attempted to understand, define, and imply (without direct accusation of inflicted injury) that caretakers had suddenly started seriously injuring or killing infants by violent shaking out of frustration and rage because there seemed no other reasonable explanation to him for injuries without signs of battering, although he did properly list "differential diagnosis" as other causes but failed to do the needed tests to eliminate these possibilities. However, "infantile whiplash shaking syndrome" was accepted almost without question in earlier days by rumor and innuendo, without a peer-reviewed challenge, by a public left unaware that it lacked an underlying foundation of science to support it.

Perhaps people could secretly identify with the idea of a person pushed over the edge, "losing it", and violently shaking and slamming an inconsolably crying infant down in a crib in a moment of temporary insanity and were quick to condemn someone who appears to have acted on these irrational impulses. At the same time, this kind of "kneejerk" condemnation is made without considering that while such irrational urges may pass through our minds momentarily, there are powerful forces of nature that prevent infanticide in most people, and no immediate explanation as to why they would start losing control a few decades ago and then only in certain areas in the industrialized world.

In 1968, Dr. Ayab Mammoya conducted studies on primates to determine scientifically if whiplash could produce brain injury? He proved that tramatic injury to the brain--subdural hematomas or diffuse axonal injury--did occur and the point at which it happened which was at approximately 155 "g's" of acceleration force. John Caffey, obviously feeling vindicated after his own doubts, called Mammoya up in person to thank him for his article and afterwards published articles in 1972 and 1974, further promoting his theories on the subject. However, "Today, Mammoya is adamant that he told Caffey that acceleration-deceleration involved in the monkey experiment were much greater than he believed could be generated by a human."  (Military Law Review, Vol 188, P. 8)

Why Caffey ignored or dismissed Mammoya's reported warning is unknown. In a published article in 1946, "Caffey J. Multiple fractures in the long bones of infants suffering from chronic subdural hematoma. 1946;56:163-173. Am J Roentgen Rad Ther" he came short of suggesting "intentional injury". But when he published on the topic again 1972 and then in 1974, he claimed that babies get shaken and what the effect was, in his opinion, but he took his "shaking alone" theory a step further:

PEDIATRICS Vol. 54 No. 4 October 1974, pp. 396-403
The Whiplash Shaken Infant Syndrome: Manual Shaking by the Extremities With Whiplash-Induced Intracranial and Intraocular Bleedings, Linked With Residual Permanent Brain Damage and Mental Retardation ...

"Habitual, prolonged, casual whiplash shakings may produce an insidious progressive clinical picture, the latent whiplash shaken infant syndrome, which is often unapparent to both parents and physicians. It usually first becomes evident at school age when minor idiopathic cerebral motor defects are first detected along with mild idiopathic mental retardation. Permanent impairments of vision and hearing may also be identified at this time for the first time when the children are 5 to 6 years of age." "This concept of the whiplash shaken infant syndrome warrants careful diagnostic consideration in all infants with unexplained convulsions, hyperirritability, bulging fontanel, paralyses, and forceful vomiting singly or in combination. The routine careful examination of the ocular fundi of all infants should provide a superior screening method for early and massive detection of pathogenic whiplash shakings along with radiographic examination of the long bones for confirmation in appropriate cases." --John Caffey MD He included, "The actual number of such cases is incalculable from current evidence but it appears to be substantial." This suggests that the caretakers of any child presenting with these symptoms should be assumed guilty of child abuse and sent to prison for assault and battery or attempted murder. Since around 25% of all school children have been categorized as learning disabled the "actual number" might run into the millions in the US alone. Mild idiopathic cerebral motor defects along with mild idiopathic mental retardation Permanent impairments of vision beginning at age 5-6 Permanent impairments of hearing beginning at age 5-6 Unexplained convulsions Unexplained hyperirritability bulging fontanel paralysis forceful vomiting singly or in combination Caffey thought all babies should be examined for ocular fundal changes (which requires specialized equipment) and should regularly have their "long bones" x-rayed. The criteria for "shaken baby" has changed. Today, the finding of retinal hemorrhage and/or subdural hematoma alone cause doctors to jump to conclusions and assume child abuse ...if at home. If found after birth in the hospital or after proven accidental injury, suddenly the same symptoms have causes other than abuse. But if we follow Caffey's suggestions, examinations would also need to include routine x-ray exams of the ribs and clavicles, MRI's of the brain to check for swelling, hemorrhaging and skull fractures, full body checks for bruising and numerous other signs found on babies currently assumed to be victims of shaking/impact.

Mammoya's stated warning to Caffey gained credence in 1987 when Dr. Ann-Christine Duhaime demonstrated experimentally that humans could only produce around 9.3 "g's" of force, when around 155 g's were previously found to be required to produce even 1 of 2 symptoms (subdural hematomas or diffuse axonal injury), which meant that caretakers could not produce these injuries by shaking alone. Even though subdural hemorrhage and/or retinal hemorrhage alone are being used to accuse caretakers, the symptoms in assumed SBS cases usually include hypoxia (lowered oxygen--a cause of brain swelling resulting in hemorrhaging in itself), skull and bone fractures--particularly in the ribs and clavicles, the appearance of healing fractures in different stages, abnormal bruising and other signs, still without direct evidence of intentional physical abuse since the bruising seen in some cases bore no proximity to internal injury sites. Babies might present with ecchymoses on the face or body, but not in the area of broken bones, or with skull fractures, but with no bruising or swelling on supposed impact sites. As previously stated, no reliably witnessed act of shaking has ever produced the symptoms associated with SBS with proof that shaking caused them, nor has there been any evidence against these symptoms pre-existing in the form of medical conditions which cause the same symptoms--infantile scurvy, endotoxemia, blood histamine toxicity, and other infections or diseases.

In recent years a physician who was alerted by the field work of internationally-known Australian physician Dr. Archie Kalokerinos, who wrote a book, published articles and gave lectures on the dangers of vaccination and the resulting vitamin C deficiency problems, wrote more precisely about the causes of these problems, presenting the science to support the theories and field work successes in resolving it. He devoted the rest of his life to addressing the condition that was far more probable and likely than "shaking" to cause the conditions associated with SBS. He also re-examined Caffey's cases and conclusions and made sense out of nonsense and "junk science". Dr. C.A.B. Clemetson, MD, an internationally-known expert on Vitamin C deficiency who had books and many published articles to his credit, submitted his findings to the Journal of American Physicians and Surgeons Volume 11 Number 1 Spring 2006  "Caffey Revisited: A Commentary on the Origin of “Shaken Baby Syndrome”  This noted physician spent the end of his career and life attempting to educate the medical profession and scientific community about little-known causes and the extreme dangers of vitamin C deficiency which created symptoms identical to those attributed to "shaking."

He addressed what be believed to be the medical misdiagnosis of SBS cases as abuse rather than disease and how to stop many of the very real but easily explained SIDS cases since one of the known signs of vitamin C deficiency is "SUDDEN DEATH." Dr. Clemetson continued to present his shattering scientific evidence to a seemingly disinterested audience of his peers at the risk of his own personal reputation and  professional standing, just as Dr. Kalokerinos had before him. Instead, his medical colleagues appear to embrace the theoretic, unproven "Shaken Baby Syndrome" as though it had a solid scientific foundation.

If does not. Until doctors in each case of suspected abuse use differential diagnostic testing to eliminate other causes, lives will be destroyed on the basis of symptoms which have many other causes. Even worse, what may be a highly preventable cause of SIDS and "SBS" symptoms goes on.

Why would doctors and scientists ignore or refuse to test for differential diagnosis to eliminate other causes when published guidelines instruct them to do so? Why would any competent professional apparently chose to ignore or reject any notion of medical misdiagnosis? Consider the impact on their credibility and livelihoods and the inferred legal and professional liability if a medical cause was proven in most present cases. That could potentially indicate that generations of victims world-wide have been falsely accused and wrongfully imprisoned. That might be reason enough.

A similar situation is ongoing in the present autism-vaccination link controversy, made more explosive with the recent revelation of a published study using primates to test the reaction to the same vaccine schedule that human infants are put on, with the documented findings of various levels of autism-like and other neurological symptoms developing in the vaccinated monkeys.

Wouldn't it be interesting if this same kind of primate study was expanded to include feeding the gestating females a deficient diet of "white man's food", given sugar, coffee, and nicotine to emulate smoking mothers, treated with antibiotics and antihistamines for any kind of infection preceding, following or triggered by vaccinations, and fed on baby formula?

That Caffey may have guessed wrong mattered little. People liked the "whiplash-shaken" theory, grabbed it, and ran with it without challenging the lack of scientific analysis behind it. The irony of a theory implying that caretakers suddenly, without explanation, started to injure or murder infants against all natural instincts, and that they did it selectively, in certain countries and not in others or at different ages in different countries (India reports almost no SBS cases and Japan, after changing the age of vaccination saw a corresponding change in the median age of SBS and SIDS cases)--seems lost on professionals in the field, along with logic, common sense, and mens rea: evidence of malice aforethought or sudden and spontaneous criminal intent. In fact, there has never been a single witnessed incident of shaking/impact that resulted in SBS symptoms and confessions are unreliable for many reasons. People may gently shake an infant to try to rouse it, or "confess" by way of a plea bargain to save a spouse from being threatened with prison or the inevitable threat of a much longer sentence, guilty or not, or for a number of other reasons short of the truth.

In fact, even in cases where excess shaking is admitted to and happened, the usual cause is "inconsolable crying" which is often a symptom of vaccine-induced encephalitis, suggesting the SBS symptoms may have preceded the shaking, and had nothing to do with the actual shaking incident, although shaking could obviously have made a medical condition worse in a case of brain swelling and/or "capillary fragility" or caused injury that wouldn't be seen in a less medically damaged infant.

Tragically, Caffey's "assumptions" arose from unproven science and unwitnessed but assumed abuse ...if there were no clear signs of battering, therefore the dead infant "must have been shaken to death." It was guessing. Dr. Caffey did list "differential diagnosis" (other causes) including infantile scurvy in each of the cases he wrote about, but all of the classical signs of scurvy were not present as a group in each case, although individual signs of scurvy were. However, infantile scurvy--"Barlow's disease"--normally showed up in babies over 7 months old, resulting from vitamin deficiency due to feeding on baby formula or an otherwise inadequate diet, so it wasn't expected to be seen in infants. Caffey admitted his theory was based on the flimsiest of science, but that it caught on anyway. In short, the unproven theory of "Shaken Baby Syndrome" took on a life of its own outside the realms of medicine and science. It provided someone specific to blame--the last caretaker with the baby when the crisis came. It certainly takes the heat off of doctors. And many babies are slightly shaken because when an infant stops breathing or becomes otherwise unresponsive or begins having seizures, the most normal reaction in the world is to shake it a little to "wake it up", or in the case of infant CPR training, to (gently) "shake and shout" to determine if there is any response at all, which is required before breathing into the lungs and pumping the heart. This was standard CPR training. 

A rare acquittal: MOM WINS SHAKEN BABY APPEAL "The defense had maintained throughout the January 2006 trial and the September appeal submissions that evidence did not necessarily support shaking as a cause of death, but if shaking did occur, it was only because a desperate Schoenthal had been trying to bring her son out of a lengthy seizure."

This can lead to a tragic and possibly intentional misinterpretation when terrified and traumatised caretakers add to the mythology by admitting to "shaking the baby" without realizing an attempt to save a precious life will almost always evolve into a criminal charge of "shaken baby" where the caretaker is accused of causing rather than responding to the very condition that created the crisis in the first place. At that point logic, reason and any search for other causes or actual evidence of criminal actions seem to fly out the window.

That means disregarding the recent scientific evidence suggesting the impossibility of manually shaking an infant hard enough to do serious or lethal damage without injuring the neck and spine first, or without an impact to the head comparable to a 2-3 story fall that would leave bruising, swelling, and contusions as external signs of battering. One excuse made is that slamming a baby on a soft surface wouldn't cause external trauma signs, but would a mattress cause a hard enough impact to cause massive bleeding? Newer studies suggest not.

The standard explanation for injuries caused by "shaking" involves the smaller size of an infant brain in a larger skull and the idea that the brain can bounce around inside the head when shaken, in spite of a cushion of water around it, which is why it's called "Shaken Baby Syndrome". A new development could throw this theory into chaos, and that is the finding of supposed "Shaken Child Syndrome":

http://pediatrics.aappublications.org/cgi/content/full/117/5/e1039 Published online May 1, 2006 PEDIATRICS Vol. 117 No. 5 May 2006, pp. e1039-e1044 (doi:10.1542/peds.2005-0811) -------------------------------------------------------------------------------- EXPERIENCE & REASON Findings in Older Children With Abusive Head Injury: Does Shaken-Child Syndrome Exist? Hani Salehi-Had, BAa, James D. Brandt, MDa, Angela J. Rosas, MDb and Kristen K. Rogers, PhDb a Department of Ophthalmology, University of California Davis Medical Center, Sacramento, California b Department of Pediatrics, Child and Adolescent Abuse Resource and Evaluation Diagnostic and Treatment Center, University of California Davis Children's Hospital, Sacramento, California ABSTRACT: Shaken-baby syndrome (SBS) has been hypothesized to occur after shaking by an adult during the first 2 years of life. We wondered whether it is possible to achieve rotational forces sufficient to cause SBS-like injuries in children >2 years of age. The present study describes cases of child abuse in older children who presented with the classic ophthalmologic and intracranial findings of SBS. In this case series, 4 cases of older children (2.5–7 years old; 11.8–22 kg) who died from abusive head injuries and who had diffuse retinal hemorrhages identified antemortem were selected for review. The cases were abstracted from hospital charts, records from autopsies, coroners' and district attorneys' offices, and court transcripts. In all 4 cases the history provided by the primary caregiver did not match the severity of the injuries*. Three case subjects presented with patterned bruises. Multi layered retinal hemorrhages and acute subdural hematoma were observed in all 4 cases. At autopsy, diffuse axonal injury was evident in 3 of the 4 cases; all 4 cases had optic nerve sheath hemorrhages. None of the victims had skeletal fractures on radiologic examination or at autopsy. This case series demonstrates that it is possible to observe SBS-like retinal and central nervous system findings in the older and heavier child. Our findings underscore the need for providers to consider intentional shaking as a mechanism of injury in the evaluation of abusive head injury in older children.

*This means that abuse was neither witnessed nor admitted to, and was assumed due the given history not matching the severity of the symptoms without differential diagnosis to eliminate other causes.

John Caffey listed Barlow's disease (infantile scurvy) as a differential diagnosis in the cases he examined and wrote about, however in modern cases where shaking/impact is suspected--any other investigation medically and legally usually comes to a grinding halt.

According to Dr. Clemetson, "Retinal petechiae, subdural hemorrhages, and even broken bones do not always indicate trauma or child abuse. Infantile scurvy or a variant form still occurs today and can be mistakenly diagnosed as nonaccidental injury (NAI). Histamine levels, which are characteristically increased in vitamin C depletion, may reach a toxic level owing to infection or the

injection of foreign proteins. Histamine intoxication can cause a variant of Barlow?s disease, with weakness of the retinal vessels and the bridging veins and venules between the brain and the dura mater in infants."

"...an infant can die with extensive retinal hemorrhages, a blood clot under the capsule of the brain, extensive bruises, broken bones and sores that will not heal, due to Barlow's disease without having been subjected to anything but the tenderest of loving care."
--Dr. C. A. B. Clemetson, MD

Another pioneer, Dr. Archie Kalokerinos, who received Australia's highest civilian honor for his work among aborigines suffering up to a 50% death rate following vaccinations (book: "Every Second Child")--"There is no doubt that it is possible to shake a baby to death. But in more than forty cases that I have investigated there has been real evidence to suggest strongly that the babies were not shaken but the hemorrhages that were found at the autopsies which could be in the retinas, in the brain or the membranes surrounding the brain are caused by disturbances in coagulation-bleeding factors. And the so-called fractures that are found in these babies are not true fractures. That is they are not inflicted injuries, they are due to an increased utilization of vitamin C caused mainly by the presence of bacterial toxins." 

http://tinyurl.com/5b475g 
Handbook of Nutrition and Ophthalmology By Richard D. Semba, M.D. 
Chap. 9  Vitamin C and eye health   P.377

The following photo shows an extreme case of "exophthalmos" where hemorrhaging behind the eyeball makes it bulge out. Infantile scurvy is a hemorrhagic condition. There are far more causes of vitamin deficiency than poor diet and many more symptoms and side effects than those listed here, including ...SUDDEN DEATH.

 

Child abuse exists. We all know it happens and the failure to recognize it in time to save a child from misery, injury or even death is unthinkable. But to falsely accuse a caregiver of abusing a child and to set in motion all of the consequences that follow such a grievous error--the horror, devastation and loss it brings to a family--is equally tragic. A mistaken diagnosis of inflicted trauma (NAI-"non-accidental injury" or NAT-"non-accidental trauma"), especially to the head, is "one of the gravest injustices of modern times", according to F. Edward Yazbak, MD, FAAP. He went on to say that "many have recently questioned the existence of the so-called 'Shaken Baby Syndrome' and the concept that the last caretaker must have been guilty. Careful reviews often uncover relevant findings that were missed or ignored. Recent pediatric vaccinations have been suspected as precipitating factors."

Read Dr. Yazbak's article at the National Vaccine Info Center. His article focuses on multiple vaccines. This story begins with just one: the Hepatitis B vaccination...for fragile newborns, a group with such high numbers of vaccine injuries that people in France staged demonstrations against Hep B.

 

 

 

Another Voice Of Reason: "Apparent Life-Threatening Events (ALTEs), as defined by the National Institutes of Health, encompass all the findings hitherto attributed to "Shaken Baby Syndrome" (SBS), and may follow routine vaccination. Vaccines may also induce vitamin C deficiency (Barlow's disease), especially in formula-fed infants or infants whose mothers smoke. This could account for some of the changes seen in these infants, including hemorrhages, bruises, and fractures. Vitamin C deficiency should be excluded in patientsuspected to have SBS." --Dr. Michael D. Innis, MBBS, DTM&H, FRCPA, FRCPath, honorary consultant hematologist, Princess Alexandra Hospital, Brisbane, Queensland, Australia.

In fact, there are many people investigating and reporting on the potential devastating effects of vaccination, infection, antibiotic use and accidental short falls that produce symptoms identical to those attributed to child abuse. The small but increasing group of courageous physicians and scientists now speaking out have much to say. And for the particular symptoms associated with vaccination and related adverse effects, even a new name: Clemetson-Kalokerinos Syndrome (Barlow's disease variant: accelerated infantile scurvy-endotoxemia) after the towering pioneers in the field of medicine sounding the alarm and ringing the bells in a call to arms--not guns or missiles--but in a vigorous battle cry for better science and differential diagnostic testing to separate the innocent from the guilty.

Unproven Assumptions, Medical Ignorance or Fraud Leading to Misdiagnosis Cause of Tragedy For All Involved
Unproven assumptions, false or misleading statements by doctors to investigators, tainted confessions and plea bargains coerced by threats of trial consequences, medical misdiagnosis due to a lack of Differential Diagnosis, incomplete or inadequate forensic pathology--sometimes by those without proper training, defective or rushed autopsy exams, biased interpretations of findings ...there are countless factors which may complicate these cases and subvert both truth and justice, particular when there are tests that can separate the innocent from the guilty and they aren't being done. Detailed instructions for doing proper legal and medical investigations are available in published medical guidelines for emergency pediatrics but are almost never done in suspected SBS-related abuse cases, making SBS "unique" in all of medicine.

Child abuse remains a terrible reality and it happens every day. But the rush to accuse and convict in an over-eager effort to identify and remove abusers from society, or for other reasons almost too unconscionable to consider if it turns out that doctors are intentionally blaming innocent caretakers, also leads to devastation to infants, their caretakers and the families of everyone involved in these cases.

Even worse, infants who survive long enough to get to the hospital are put at greater risk of permanent injury and death when they are diagnosed as victims of abuse in cases where they are suffering from treatable conditions and diseases. Medical misdiagnosis can kill. Consider if an infant is suffering from one of several hemorrhagic conditions and is given blood thinners, which is often the case. It could die from massive bleeding caused by medical treatment, which is then blamed on the caretaker instead. Or what if the proper treatment was a simple nutritional supplement like Vitamin C which was being overlooked? In these cases, misdiagnosis becomes medical malpractice. Those who see the signs too late have a strong incentive to hide the facts and focus the blame on caretakers. Many probably never have a clue because they haven't looked past the kind of medical dogma that will eventually be looked upon as one of the darkest periods in medical history.

Next: THE JOHN LAVERTY STORY (Under Construction)