https://www.themarshallproject.org/2023/09/15/texas-shaken-b...
It is so emotionally charged though that there is and has been great hesitation to assign this cause of death because of the emotional effect on the parents.
It was Molière (<1622 - 1673), who wrote a play that featured an apothecary (explaining the functioning of opium to laymen), but no examinations.
B. infantis and human milk oligosaccharides create a feedback loop that encourages the formation of a robust immune system during a critical period [1]. Some formulas contain b. infantis, and some contain 2'FL, the HMO present in breastmilk. The most robust strain is EVC001, which has been shown to be present at a year after 21 days of supplementation. In an observational study, it reduced the diagnosis of necrotizing enterocolitis in very low birth rate infants by 73% [2].
I wish this was common knowledge, but most formulas do not contain these (often they contain other pre and probiotics) and babies are missing out on the specific sugars and bacteria that we know impact the development of the immune system.
1. https://www.cell.com/cell/fulltext/S0092-8674(21)00660-7 2. https://pubmed.ncbi.nlm.nih.gov/35032555/
https://journals.plos.org/plosone/article/peerReview?id=10.1...
I've certainly had peer reviewers trying to get me to cite their own papers in my articles, however I've never seen an instance where a peer reviewer alleged that an article I've cited was by someone disreputable.
https://web.archive.org/web/20101218031844/http://www.medsch...
People will probably find it offensive but it does explain a lot about why the stuff being taught is almost always not questioned.
This post in particular:
https://web.archive.org/web/20101211180021/http://www.medsch...
This seems to have led to the pendulum swinging too much in the opposite direction, where they now seemingly force foster kids to meet their biological parents against the kid's will[2]...
[1]: https://rett24.no/articles/norge-felt-i-ni-nye-barnevernsake...
[2]: https://www.nrk.no/norge/mener-fosterbarn-presses-til-skadel...
Not like it hasn't happened before. And you're overestimating the required massiveness of the conspiracy IMO.
https://www.seattletimes.com/seattle-news/child-abuse-or-med...
This also reminds me a lot of the indoctrination we went through at the hospital when my daughter was born.
Despite being a high risk pregnancy we were railroaded into a natural birth. After nearly 24 hours of horrific labor she spiked an extremely high fever and they had to do a c-section, making us feel like failures. They found that our daughter wouldn’t have made it otherwise.
We were castigated because my wife took medicines that entered her milk and were made to feel like failures for considering not breast feeding. She had to pump milk at five AM before she took any medicine to minimize the exposure to the extremely toxic medicine that would be present in her milk. She didn’t produce enough milk and we were at wits end. The nurses and doctors at the hospital were unhelpful and treated us like abusers. When we went to our local pediatrician he laughed and said entire generations were raised on formula and to stop killing ourselves. It was the best advice we were ever given.
Likewise my daughter couldn’t sleep on her back. She wailed every night. I read everything I could find on SIDS and I realized the correlation for back sleeping was very weak - almost statistically irrelevant - and even then the prevalence of SIDS was very low. Yet I knew for 100% my daughter wasn’t sleeping. I knew if I told anyone I would be lectured, and I worried might even be reported. The after nearly a week of not sleeping I flipped her over one night with my heart pounding. She fell asleep immediately. She didn’t die.
She’s nine now and an incredible athlete and has a sharp and brilliant mind. None of the doomsday stuff occurred. No autism, no weak immune system, no weight problems, intellectual deficiency, or all the other warnings we were given about c-section, formula, or belly sleeping. Over the years I continued to read the research and there’s basically nothing compelling about any of this advice, at least not at the level of stridency parents experience.
AI can lie. It means a "truely personalized medicine" would sometimes poison its patients. See for instance Donald Knuth experiment with Chat GPT, starting with "Answer #3 is fouled up beautifully!" with some totally wrong AI answers https://www-cs-faculty.stanford.edu/~knuth/chatGPT20.txt
Of course medical science could make a better use of statistics, get help from AI, and discern more profiles (e.g. one US adult out of two is obese, and it's often unclear how to adjust medication to person mass). But that's a long process, with no obvious path, and much distinct from the magic "AI will solve it all".
I also found this argument absurd: I was suspected of losing my temper on my child, and it's my calmness that was interpreted as a sign of danger!
It reminds me the Robert Roberson Texas death penalty case that John Grisham recently wrote about [1]: "He told hospital staff that she had fallen out of bed, but they didn’t believe him. They didn’t know he was autistic and decided he didn’t show the proper emotions given the dire situation."
[1] https://www.wsj.com/articles/texas-may-execute-a-man-based-o...
Most parents don't realize that anytime they interact with a medical doctor (or another professional), they interact with someone who was trained to detect "signs of abuse", which basically can be anything out of the ordinary. They are required by law to report any suspicion of abuse, and they can be prosecuted if they fail to do so. The incentives are pretty clear. Unfortunately, while this obviously protects some children, there are adverse effects such as an enormous waste of human and financial resources to unsubstantiated reports [2].
To quote Wikipedia (this is more generally about hotline calls but this also affects healthcare professionals):
"There are approximately 3.6 million calls each year nationwide (..) affecting on average 1 out of 10 U.S. families with children under the age of 18 each year (there are 32.2 million such families). (...) Of those substantiated, over half are minor situations and many are situations where the worker thinks something may happen in the future.
Each year, approximately 85% of hotline calls either do not warrant investigation or are not substantiated. Approximately 78% of all investigations are unsubstantiated and approximately 22% are substantiated, with around 9% where "alternative responses" are offered in some states, which have a focus on working with the family to address issues rather than confirming maltreatment."
On this topic, I highly recommend "Take Care of Maya" on Netflix.
[1] https://en.wikipedia.org/wiki/Mandatory_reporting_in_the_Uni...
[2] https://lawreview.law.ucdavis.edu/issues/50/1/Articles/50-1_...
[3] https://en.wikipedia.org/wiki/Factitious_disorder_imposed_on...
https://www.theguardian.com/world/2023/sep/24/texas-death-ro...
I think it's reasonable to say that billions of babies may have been shaken in the past, yet the vast majority (of the order of 99.9% or even much more? [2]) are not diagnosed with shaken baby syndrome, since this diagnosis has an incidence of ~1/3,000 among children < 12 months in developed countries. In the countries where the incidence of shaking appears to be >50%, it is striking to note that the SBS diagnosis actually does not exist, i.e. doctors are not trained to diagnose it.
On the other hand, actual cases of severe inflicted head injuries probably affect < 1/10,000 children < 12 months, and I think most of them involve external evidence of trauma. Those that do not probably involve extreme forms of shaking far beyond what most of the billions of "shaken babies" sustain.
In other words, I've come to the likely conclusion that the intersection of babies who are effectively shaken, and babies who are labelled with "shaken baby syndrome", is an abysmal proportion of the first set, and a small proportion of the second.
[1] https://www.sciencedirect.com/science/article/pii/S074937970...
[2] Excerpt from the paper above: "the ratio of children hospitalized or dying from inflicted neurotrauma compared to the numbers of reported shaken children may be estimated at 1 to 152."
https://en.wikipedia.org/wiki/Thirteenth_Amendment_to_the_Un...
https://www.aclu.org/news/human-rights/captive-labor-exploit...
We got 800,000 or so right now. Fight unemployment? Lock more people up.
Anyway, we don't need this level of scientific detail and knowledge to say that no one should ever shake a baby. All brutal gestures are obviously harmful and dangerous.
[1] https://link.springer.com/article/10.1007/s00381-022-05577-6
In other countries the clearance rates are as high as ever. The US is an exception in many aspects in the West, closer to third world countries depending on what metric you look at
> overall, findings showed that the clearance rate in Finland and Switzerland in the years of analysis was very high, in some years of the analysis even reaching 100 percent. Internationally, these rates are extraordinary high, even in comparison with other European countries such as Italy (67 percent and, later, 78 percent) , Estonia (80 percent), England & Wales (85 percent) and France (80 percent)
https://journals.sagepub.com/doi/full/10.1177/14773708187648...
To be honest the text you are quoting doesn't talk about Western Europe at all, and I think if you exclude Western Europe, then "Northern America + Eastern Europe" is most of what remains of "western countries". Australia and New Zealand, while part of western countries, are so small that they are basically insignificant for statistics.
The data in the source[0], though, says the number of prisoners in Europe as a whole (as well as Northern America) has decreased (Figures 10, 12, and 13) confirming what GP said. Eastern Europe is quoted specifically because the decrease has been much more important (basically, the numbers are becoming similar to Western Europe).
There's no question that the trend in the West has been a decrease in incarceration rate, with Australia and New Zealand clear outliers.
[0]https://www.unodc.org/documents/data-and-analysis/statistics...
That's exactly it. I'd love to discover scientific literature about this phenomenon, and I'd also be surprised if it doesn't already have a name and an extensive literature. But if that's the case: I think there are research carriers in psychology to make here...
Edit: ChatGPT found "belief perseverance" [1] but, again, that's not exactly what we're talking about, which also relates to a personal sense of morality and "being one of the good guys".
https://3dc.org.uk/press-release-preliminary-study-of-uk-sha...
Louise Woodward was the nanny involved and the court case was televised. Was huge at the time I remember.
[1] https://www.sciencedirect.com/science/article/abs/pii/S00029...
[2] https://academic.oup.com/nutritionreviews/article/54/7/203/1...
According to Wikipedia, as to the distribution of this condition,
> The birthmark is prevalent among East, South, Southeast, North and Central Asian peoples, Indigenous Oceanians (chiefly Micronesians and Polynesians), certain populations in Africa, Amerindians, non-European Latin Americans and Caribbeans of mixed-race descent.
So you can see how, in a Western European nation, even if no-one is being biased in the sense of "hating foreigners", the false accusations would cluster in "non-indigenous" populations, for want of a better word (I originally had "immigrants" then realised that isn't the correct split I'm looking for.). Personally I believe there is no defense for doctors, courts and social workers not knowing about this and checking for it before making any accusations.
This doesn't seem to apply to Romanians / Eastern Europeans specifically, unless they have partly Asian ancestry, but it does show that there are conditions that can be mistaken for abuse that appear in some cultures more than others.
Obviously a parent who is spending nearly all their time with a newborn knows them best and is likely able to make the best judgement about what works for the child, but the purpose of the advice is to avoid a class of scenario that occur most often. due to issues that are very difficult to detect and often go completely undiagnosed, as they pertain to early development and often improve naturally over time.
The technical report by AAP the other year does an excellent job of presenting the current evidence in an as objective way as possible, I highly recommend it:
https://publications.aap.org/pediatrics/article/150/1/e20220...
You will note that efforts are being made to disentangle diagnoses from the broad SIDS label and that while SIDS cases are trending downwards, it's likely due to both proper classification and education.
The point of preventative measures is to avoid the issue entirely. Sure, tummy sleeping might not be a problem for you (or maybe it was and you just got lucky!) but by generally recommending back sleeping, a class of issues is avoided.
So all in all, I really don't see this as bullshit at all. Caveat that you gotta do what you gotta do, but I'd rather this advice persist than not. We should hope that no one ever has to endure the loss of a child.
> Evans said the syndrome remains a fair medical diagnosis and also notes in the report that SBS was not the sole cause of child's death.
There ought to be a law where lawyers deal with legal interpretations and advice and medical doctors deal with medical interpretation and advice.
In a sane world, she'd be taken off the bench until she completes some remedial legal coursework and several dozen hours of medical talks from this century.
[1] https://www.cbs19.tv/article/news/local/judge-denies-recommending-east-texas-death-row-inmates-appeal-exoneration-new-trial/501-39bfdd8e-b687-4065-9b34-25b60c320e6cThat's your assumption.
You're missing the point, which is that you can supplement formula with both 2'FL and b. infantis and get immune system outcomes that are more similar to those that occur while breastfeeding [1]. The fact that milk typically faciliates a cascade of changes that lay the foundation for a healthy immune system is not at odds with formula feeding. Formula is adequate macronutrition, but if we cannot be honest about the ways in which it is not on par with breastmilk, we will never close the gaps.
1. https://www.nutraingredients.com/Article/2023/05/18/Abbott-s...
Also, the Innocence Files is a must-watch on Netflix [3].
[1] https://innocenceproject.org/
Let's imagine a mother seeing her baby who suddenly stops breathing. Panicked, she gently takes her baby under the armpits: "Please wake up!". The baby is brought to the hospital, doctors find subdural and retinal hemorrhage, she is accused of shaking her baby.
At the police station, investigators are told by doctors that SBS is 100% certain, that the baby was shaken just before collapsing. They keep pressuring the mother, who swears there was no shaking, no trauma, no accident, no short fall, absolutely nothing. The baby just collapsed with no triggering event. This is a story that is repeated again and again by most parents and caregivers who are living this situation.
This is such a dramatic and emotional situation for parents and caregivers that many will actually doubt their own memory (that actually happened to me, briefly, and yet I never went through a tough police interrogation in custody). Anyway, innocent and sincere persons will actually try to find rational explanations. They will retrospectively try to find any sort of mild movement of the baby's head that could resemble shaking. Police officers will say what they're told (which is actually true): mild shaking will not cause this, only extremely violent ones will.
At one point during the interrogation, the idea will be brought up that, perhaps, the mother accidentally shook the baby after the collapse as a resuscitation attempt. In the end, it may well be the only rational explanation? The mother may even end up believing that she involuntarily harmed her own child while trying to save him, and that will be the charge brought by the prosecution that leads the mother to trial.
In reality, this gesture was likely to be far too mild to do any serious injury to the child. However, in this particular context, it may well be the only explanation that could be accepted by both the investigators and the defendant. In these cases, it's more likely that the child collapsed due to some undetected medical condition leading to a respiratory arrest (akin to what happens in SIDS).
I've seen this pattern over and over again. It has actually be well studied by psychologists in slightly more general contexts. The book contains 2 chapters (by Keith Findley, Richard Leo, Deborah Davis) on the extremely important issue of SBS confessions, as this is basically the main evidence of the diagnosis today.
[1] https://en.wikipedia.org/wiki/False_confession#Coerced_inter...
https://en.wikipedia.org/wiki/Experiential_avoidance
https://en.wikipedia.org/wiki/Denial_(Freud)
HN and software engineers have bias to over-focus on the cognitive, but I think the key experience here is emotional distress.
We can close the gaps by subsidizing Evivo's EVC001 b. infantis and making it a standard that every formula contains 2'FL. Individuals can choose these formulas and purchase b. infantis already. If we were to make it so that all babies, not just NICU babies at hospitals aware of the research, get these two things, public health outcomes (especially those related to autoimmune conditions) should be better than if we continue allowing formula that is not as analogous with breastmilk. We can have better lactation support that is current and evidence based (such as that from ABM contributor Katrina Mitchell https://physicianguidetobreastfeeding.org).
Another reason mom blogs are toxic is because people read past others points when issues are really emotionally charged for them. Really sorry your wife struggled. Formula is fine, but there are reasons breastmilk is pushed, especially since milk is supply and demand and it's hard to identify those with true low supply and those whose bodies just haven't ramped up production yet. Hopefully as a model of immune system response and the impact of b. infantis and HMOs gains more awareness, there will be less pressure since we are assured babies are getting many of the same benefits.
https://www.nbcboston.com/investigations/massachusetts-dcf-e...
CPS is a human organization. There are no algorithms and the guidelines rarely perfectly fit the situation a case worker is given. Keep this in mind. CPS is horrifically under funded meaning that intelligent and competent staff readily leave the field for better paying gigs.
The biggest problem I see with foster care at large is the rampant classism, sexism, racism, and other isms. The providers tend to be solidly middle class degree bearing people who have no personal connection to primary instigating factors of foster care involvement. Namely and typically presenting cross generationally: poverty, crimes of despair or desperation, and trauma whether that be internal or external to the family unit or community such as neighborhood violence, caregiver assault, or tragic loss.
It easy for providers to casually profile incoming children and their families as poor uneducated violent predacious drug dealing junkies. Providers are given extreme control over the entire family and their extended relations and use this power to coerce whatever behavior they desire out of the people. If the provider dislikes the family they have a lot of tools to inflict suffering on them and oppositely they have a lot of tools to assist families and keep them together.
Honestly, the entire system is such a god damn mess that it should be rebuilt with the same level of distrust of staff that they can exercise against families.
Perhaps the most pressing single metric to focus may be the foster to prison pipeline.
Sorry for the meandering post, bookcases could be filled with anecdotes and descriptions of the flaws in these systems. In general, I think the failure of child protection agencies reflects the decay in America at large. I could point to stuff like broken family units or loss of religions community but I’m not dog whistling here. Stable healthy nurturing familial units of any relation are obviously better but man in the house rules and other racist/classist measures caused more harm. I’m also vehemently opposed to all major organized religions that are regularly used to justify war and protect child sex predators. Perhaps the collapse of American industry and slow erosion of social safety nets has hastened the social collapse. Perhaps the internet had instigated the collapse of communal organizations. Perhaps winner take all government enforced monopoly capitalism is the cause. Perhaps it was the theft of 50,000,000,000.00 from the bottom 99 by the 1% that lead to this. Regardless, the solution is not going to be found in rebuilding foster care when our social fabric is rotten.
0. https://srcd.onlinelibrary.wiley.com/doi/10.1002/sop2.10
1. https://www.crimlawpractitioner.org/post/the-foster-care-to-....
3. https://nlihc.org/resource/study-examines-man-house-rules-vo...
4. https://time.com/5888024/50-trillion-income-inequality-ameri...
Here's one among thousands of examples, from a really terrible paper by one such powerful SBS proponent here in France [1] (another of his papers was actually retracted this year [2]).
"Fake news 11: the caretakers’ denial is sincere
Clinicians and defenders can become intoxicated by the denials of parents suffering the agony of having their child in dire condition, and at the same time being grilled for their possible responsibility. The mental mechanisms of self-denial are well-known to psychiatrists. A perpetrator, after a violent burst, and faced with its terrible consequences, can experience a dissociation mechanism similar to witnesses of catastrophes, dissociation being understood as “a break between the memory, the perception, the consciousness and the identity…when faced with unbearable feelings”. Sincere denial easily elicits compassion from the medical staff as well as defenders, a natural response which is enhanced by professional training. Some authors have documented with functional imaging the sincerity of denial in a case of convicted child abuse and concluded that the sincerity of denial is not a criterion for innocence."
[1] https://link.springer.com/article/10.1007/s00381-021-05357-8
[2] https://link.springer.com/article/10.1007/s00381-023-05889-1
Part of the issue is they exist in several systems simultaneously: medical system, child-welfare system, and criminal justice system.
Are they there to cure disease, ensure the child had a safe home environment, or put an abuser in prison. Answer: all of the above.
Here’s a good example:
https://wisconsinwatch.org/2022/01/alaska-couple-loses-custo...
Our inability to judge extends to others.
It certainly deserves a better name.
Fractures among children: incidence and impact on daily activities
https://injuryprevention.bmj.com/content/4/3/194
wherein we discover that kids 0-12 break bones at an incidence of 128 per 10,000. Over 12 years that's more like 1536 or about 15% of kids if injuries were evenly distributed, although they probably aren't. Still in the right ballpark.
So serious injuries among kids are incredibly common.
If we launch investigations and get it right 95% of the time we will none the less fuck up millions of kids lives. We would probably be better off selectively investigating when there is at least some reason to believe something is afoot instead of every injury.
Norman Guthkelch himself (the first to hypothesize a causal link between shaking and subdural/retinal hemorrhage) wrote in 2012 [1]:
"While controversy is a normal and necessary part of scientific discourse, there has arisen a level of emotion and divisiveness on shaken baby syndrome/abusive head trauma that has interfered with our commitment to pursue the truth."
A French neuropediatrician wrote a medical book in French a few years ago about this issue. When interrogated by a lawyer in a symposium a couple of years ago, the author of the papers linked in my comment above said: "I haven't read this book because I absolutely can't agree with it, since it's written by one of the leaders of a denialist and revisionist school of thought".
How can you even start a discussion in a context where a Godwin point is reached with the very term they use to call you?
A single case where we a video would prove that there was no shaking at this exact moment might help convince many doctors (not all, unfortunately).
Relatedly, this recent medical article [1] reports a case of an alleged short fall resulting in subdural and retinal hemorrhage. As usual, doctors did not believe in the story of the short fall (they assume a short fall can almost never cause them) and they concluded that the short fall was a cover-up for unadmitted abuse. The police was called and, surprise, the whole thing was filmed by CCTV. The videotape proved that the story of the short fall was entirely correct and the caregiver was exculpated.
Interestingly, the doctors did not conclude that their belief was wrong (short falls almost never cause subdural and retinal hemorrhage), but that it was an "outlier".
[1] https://www.sciencedirect.com/science/article/abs/pii/S10918...
[1] https://onlinelibrary.wiley.com/doi/abs/10.1002/(SICI)1099-0...
[2] https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1440-1754....
[3] https://link.springer.com/article/10.1007/s12024-014-9600-5
[4] https://publications.aap.org/pediatrics/article/143/5/e20183...
> like Saudi Arabia is rich but not developed imho > good education, infrastructure, medical care, human rights, clean environment
Saudi Arabia's record on human rights is truly horrible (for example, recently they've started murdering refugees[0]), but the idea of whether a country is "developed" seems to be highly subjective, imho. I don't know for sure (never been to Saudi Arabia), but I'm guessing they check off all the boxes except for human rights[1]. (About a clean environment--I imagine they'd be as clean as Abu Dhabi or Dubai (the UAE) which were a lot cleaner imo or on par with Western cities. I guess this is a matter of subjective matter, but is human rights a dimension a country has to have in order to be considered developed? If human rights is indeed a dimension that needs to be satisfied, would that mean that the brutal treatment of black and brown minorities in the US by the police would make the U.S. a country that's not developed?
I'm asking this since Western European countries also have a track record that has historically surpassed world records for brutality. For example, Belgium[1] was chopping off the hands of African tribal people they had forced into labor (effectively enslaved), Germany murdered 6 million innocent Jewish people[2] and had a habit murdering people even before the Nazis in its colonies as well[3], the British were responsible for numerous famines in India as well as famine in Ireland as well as other atrocities[4], the French committed atrocities[5], so did the Netherlands and the Dutch with the East India Company[6], and Spain and Portugal (along with England and others) were highly culpable in the murder of millions of Native Americans[7].
Did these actions, at least temporarily, render these Western European countries as "not developed" countries?
[0][a] https://www.hrw.org/news/2023/08/21/saudi-arabia-mass-killin...
[0][b] https://www.nytimes.com/2023/08/26/world/middleeast/saudi-ki...
[1] https://en.wikipedia.org/wiki/Atrocities_in_the_Congo_Free_S...
[2] https://en.wikipedia.org/wiki/The_Holocaust
[3] https://en.wikipedia.org/wiki/Herero_and_Namaqua_genocide
[4] https://www.independent.co.uk/news/uk/home-news/worst-atroci...
[5] https://newlinesmag.com/newsletter/the-dark-legacy-of-french...
[6] https://foreignpolicy.com/2020/08/10/dutch-colonial-history-...
[7] https://en.wikipedia.org/wiki/Genocide_of_Indigenous_peoples
In ED and clinic I have had kids that screened positive for TEN 4 FACESp (see https://jamanetwork.com/journals/jamanetworkopen/fullarticle...). One of these babies ended up having b/l subdurals, likely abuse. In the end they may have called that "shaken baby", however there were multiple other red flags, the subdurals was only one piece, and the suspected mechanism of the subdurals was repeated drops / falls.
Agreed "shaking" may not be the mechanism but the author lists other mechanisms that can lead to subdurals and retinal hemorrhage where NAT could play role, eg hypoxia via choking, repeated falls from pushing/drops, neglect in unsafe motor vehicle situations.