They arrive at the emergency room with abrasions or fractures “incongruent with the logic with which the accident or the cause of the damage is described. They are children who have excessive trauma compared to the story of what happened. Thus the doubt of mistreatment creeps in”. In particular , “for the shaking syndrome, the presence of a retinal hemorrhage is significant. But the doubt must be verified, which is why a center with experts capable of making a correct diagnosis is needed”. Thus Giorgio Perilongo, full professor of Paediatrics at the University of Padua, director of the Pediatric Clinic and of the Women's and Children's Health department, tells Adnkronos Salute about the activity of the Regional Reference Center for the diagnosis of abused children, on the occasion of the first day of awareness and prevention of the 'Shaken baby syndrome', scheduled for April 7, at the same time as International Health Day.
Promoted by Terre des Hommes, together with Simeup (Italian Society of Pediatric Emergency Medicine) and with the support of Anpas, Fimp and the hospital network against child maltreatment, the initiative will bring, for the first time, the public spaces of 25 cities involved in the 'Nonscuterlo!' campaign, information points on 'shaken baby syndrome' and how to prevent it. In the Padua center, which participates in the initiative, “we see between 1 and 2 cases of shaking per month – continues the expert – About 5% of the Italian pediatric population suffers from a form of physical mistreatment or abuse, neglect or exposure to toxic agents. According to the World Health Organization, around 36% of children are at risk of psychological violence, less than 20% of physical violence. The risk of sexual abuse affects 13% of girls and 8% of boys.” Beyond the clinical question, the doubt of some abuse problem can arise when “a child does not have normal social and relational activity and presents a sort of neglect”.
At the origin of shaken baby syndrome, there is often “exasperation”: the baby is shaken violently because one is at the limit of tiredness, due to problems of postpartum depression, but also due to other factors because “mistreatment – explains Perilongo – it is distributed across all social, economic and cultural classes. It is not always connected to a violent parent”, but rather to the fragile one.
Of course, “there may be psychopathological conditions, but often these cases occur following moments” triggered, for example, by the inconsolable crying of the infant – the most affected are children between 2 weeks and 6 months of life – which “exasperates the parent to the point that, in a moment of reckless and unmotivated reaction, he shakes the child violently. The movement does not need to be prolonged to cause damage because the newborn's head – warns the expert – is much larger than the body and the muscles are not strong enough to counteract the stress”.
According to a recent survey, 1 in 4 cases of shaking can be lethal or lead to a coma. “In general – observes Perilongo – there can be more or less serious neurological damage that can persist over time”, such as learning, cognitive, behavioral disorders, epileptic attacks, delays in psychomotor development, blindness, spastic diplegia (paralysis of both sides ), tetraplegia (paralysis of all sides).
The Padua center, among the first in Italy, founded almost twenty years ago by Professor Paola Facchin, operates with an expanded multi-specialist approach. “The added value – specifies Perilongo – is that of being experts in formulating the diagnosis”, therefore avoiding transforming parents into monsters, but also “in managing relationships with the family and in the social world, which must give support to family”. In terms of prevention, given that cases of maltreatment are recorded within the family unit, policies in favor of the family are fundamental, but it is also important to raise public awareness, raise awareness, especially among parents, that the a child – he concludes – is a fragile subject”.
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