After a father allegedly shook his son and caused bleeding on the 4-month-old's brain last weekend, health experts said the way to prevent the next occurrence won't be by pretending such a traumatic incident can only happen to other families.
Joshua Steven Albany, 24, of Cross Lanes, was charged with felony child abuse causing injury on Monday. Police said he told them he grew frustrated because the baby was keeping him awake.
Dr. Sharon Istfan, associate chief medical officer at Charleston Area Medical Center's Women and Children's Hospital, said similar cases happen more often than people realize.
She sees a similar case about once a month, and believes cases are probably even more prevalent than that because health care providers often see only those cases that result in the most severe injuries.
"That's probably the tip of the iceberg," she said.
Police sent out a news release after the most recent arrest, but they acknowledge that some cases of abusive head trauma, formerly known as shaken baby syndrome, aren't made public.
Sgt. Brian Humphreys, spokesman for the Kanawha County Sheriff's Office, said he doesn't disseminate information about some cases because police don't want to release information until charges are filed, and often charges aren't filed right away.
"It's more common than what gets publicized," he said.
Cases significantly increased in West Virginia from 2000-2010.
The West Virginia Abusive Head Trauma Incidence Monitoring Team reviewed medical records and found about five cases a year during 2000-2005 and about 10 cases a year from 2005-2010, according to Dr. James McJunkin, professor of pediatrics at the West Virginia University Health Sciences Center Charleston Division.
The West Virginia Abusive Head Trauma Incidence Monitoring Team is a collaboration of CAMC Women and Children's Hospital, WVU Children's Hospital and Cabell Huntington Hospital, and it includes principal investigators McJunkin, Dr. Chuck Mullett, and Dr. Ed Pino.
One of every 4,000 babies sustained abusive head trauma from 2000-2005, according to an abstract of research by the team. From 2006-2010, of every 2,000 live births, one baby sustained abusive head trauma.
Some cases might have been missed, Istfan said, since she noted she sees that many cases just at Women and Children's Hospital. Those cases where children were treated in out of state hospitals would not have been included in the team's report, McJunkin said, but otherwise he feels "confident we captured nearly all cases," and that the study's numbers are sound.
Abusive head trauma typically involves children younger than age 3. According to the U.S. Centers for Disease Control and Prevention, babies between 2 months and 4 months of age are at the greatest risk, because they cry the most. The perpetrator is often a man, such as the father or the mother's boyfriend.
Each case is devastating in two ways.
It's devastating to the child, who will die approximately a quarter of the time, and can often require long-term care for numerous health conditions, including developmental or behavioral problems, seizure disorders, cerebral palsy, hearing loss or blindness.
It's also devastating for the family, which often has had no history of domestic violence, according to Istfan.
"I think it can happen to anybody," she said.
Low socio-economic status is a risk factor.
"Not everybody has that luxury of having other caregivers and getting a break from the family," she said.
However, Istfan said she has seen babies violently shaken whose families come from all walks of life.
Several health professionals indicated that stress and frustration are more likely to be the common themes among shaken baby cases. That's why cases are especially common around the holidays, when stress levels are high, Istfan said.
Dr. Rahul Gupta, state health officer and commissioner of the West Virginia Bureau for Public Health, also brought up frustration, as well as sleep deprivation.
"This is something that can happen to the best of us," he said.
He pointed to a lack of education, as well.
"We assume every adult would know how to handle a child or newborn," he said. "That is not always the case."
Officials with the West Virginia Department of Health and Human Resources are trying to fight the problem with outreach and education programs, such as home visits. Most hospitals throughout the state also now offer an educational DVD on crying and what to expect during the first few months, as part of the Period of PURPLE Crying program, which was piloted at Women and Children's and two other hospitals.
"It's important to educate the parent or caregiver, to understand that crying is worse in the first few months of life, but it gets better as the child gets older," Gupta said.
The drug problem that is rampant in the area, though, means they are fighting an uphill battle, Istfan said.
"You can be educated but, if you're high on whatever, that doesn't help a whole lot," she said. "I think that's our big challenge right now. You're not thinking rationally when you're on drugs."
As law enforcement and health officials work on the drug problem, in the meantime, they do see some hope.
"It's very much a preventable cause of death," Gupta said.
He and Christina Mullins, director of the DHHR's Office of Maternal, Child and Family Health, advocate for establishing a support system of loved ones and seeking help when you need it. They also advise parents to be prepared to walk away when the crying becomes too much, and calling a friend or relative or a parenting helpline.
"It's OK to ask for help and know where to seek help," Gupta said.
Mullins also recommended that parents call the National Parent Helpline, at 1-855-4A-PARENT, or get more information about DHHR programs during business hours by calling 304-558-5388.
"It can become very frustrating when you don't know how to help your own child," she said. "It's OK to ask for help."
Reach Erin Beck at erin.beck@wvgazettemail.com, 304-348-5163, Facebook.com/erinbeckwv or follow @erinbeckwv on Twitter.