Citation

Bechtel K, Gaither JR, Leventhal JM. Child Abuse Rev. 2020; 29(3): 282-290.

Copyright

(Copyright © 2020, John Wiley and Sons)

DOI

10.1002/car.2622

PMID

unavailable

Abstract

Since 2008, medical providers have offered the Take 5 Safety Plan for Crying (Take 5) to caregivers of newborns at Yale New Haven Hospital (YNHH); it focuses on five steps to manage caregiver frustration with infant crying and to prevent a caregiver from hurting an infant. We sought to determine whether Take 5 reduced the occurrence of abusive head trauma (AHT). Using a case-control design, we reviewed the Electronic Medical Records (EMRs) of infants younger than 12 months old who were admitted to YNHH with a head injury from June 2008 to June 2017, were evaluated by the Child Abuse Service and were born at YNHH. Cases had a diagnosis of AHT, and controls had a diagnosis of non-abusive head trauma. Exposure to Take 5 was based on documentation in the EMR at newborn hospital discharge. We used Firth's penalised likelihood logistic regression to calculate unadjusted and adjusted odds ratios (AORs). Of the cases, 11.1 per cent received Take 5 vs. 47.1 per cent of controls. In the adjusted models, we found that infants whose caregivers received Take 5 were 79 per cent less likely to have suffered AHT (AOR 0.21, 95% CI 0.02-0.99). These results suggest that Take 5 has the potential to prevent AHT in infants. 'We sought to determine whether Take 5 reduced the occurrence of abusive head trauma' Key Practitioner Messages Abusive head trauma (AHT) is an extreme form of child abuse. Crying is often a trigger for a caregiver to shake an infant, resulting in AHT. Safety planning for caregiver frustration with infant crying can help reduce the likelihood of AHT.

Language: en

Keywords

abusive head trauma; baby/infant; case–control study; child abuse; hospitals; prevention