The incidence of "shaken-baby syndrome", which can cause brain damage or death, is one in 4,000 rather than the one in 8,000 that had been reported, a study in The Lancet today shows.

The incidence of "shaken-baby syndrome", which can cause brain damage or death, is one in 4,000 rather than the one in 8,000 that had been reported, a study in The Lancet today shows.

Child abuse is the most common cause of infant death and morbidity from head injury. Seventy-eight per cent of those with non-accidental head injuries (NAHI) have long-term brain damage and developmental abnormalities.

Doctors from Edinburgh's Royal Hospital for Sick Children who did the study examined the NAHI incidence in paediatric units in Scotland 1998-99. Shaken-impact syndrome occurred with an annual incidence of 24.6 per 100,000, equivalent to 1 in 4,000 for children younger than one year. This is more than double the incidence of previous findings of 11.2 per 100,000.

The average age of the abused infants was also younger than believed, occurring at 2.2 months compared with five months. Cases of shaken-baby syndrome were found to be more common in urban regions and in autumn and winter.

Robert Minns, of the Royal Hospital for Sick Children, co-author of the research, said: "These figures will enable researchers to assess the impact of any new legislative changes banning corporal punishment... and also to assess the effectiveness of possible health education initiatives, as in the US, in preventing shaken-baby syndrome."

Chris Cloke, head of child- protection awareness at the National Society for the Prevention of Cruelty to Children, said: "This research shows the desperate need for improved support for parents both before and after the child is born... Parents must be made aware of the real and often fatal dangers of shaking a vulnerable and fragile baby."

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