Affairs: Shaken Baby Shakeup

A lot of people dislike Dr. Jan Leestma, mostly because of who pays his bills. You may have seen him testifying on behalf of Scott Peterson. Or you might remember him from the 1997 trial of Louise Woodward, the British au pair accused of shaking a baby to death, making “Shaken Baby Syndrome” a household term. It is, in fact, child-abuse cases that keep Leestma, a Chicago neuropathologist, busiest these days. And a recent study from Penn’s department of bioengineering is his latest ammunition.

One common defense to a Shaken Baby accusation is that the child sustained the injury due to a fall, not shaking. Prosecutors counter that the type of brain injuries involved in SBS cases can only be caused by child abuse — specifically, by prolonged and rapid shaking. A fall, they argue, would produce a simple linear head movement, not the rotational movement associated with children diagnosed with SBS.

But the University of Pennsylvania study, conducted by researcher Susan Margulies and published in the summer of 2003 in the Journal of Neurosurgery, found that household falls can, in fact, lead to the kind of rotation consistent with brain injuries.  Specifically, the study concluded that a five-foot fall onto concrete could cause enough rotation to hurt the brain. It also suggested that certain types of shaking were unlikely to cause severe or fatal brain injuries.

“This study is incredibly important,” notes Leestma, who uses it when testifying for the defense in SBS trials. (He says his success rate is about 80 percent — and has increased since the study’s publication.) “It says that you can’t get there from here. You can’t injure the brain by shaking a baby. You may well break their neck, but brain injury just doesn’t occur.”

Not so fast, says Margulies. When asked about Leestma’s use of her study, she cautions that her work doesn’t rule out the possibility of brain injury due to shaking, and that more research needs to be done.