Outlook Often Poor for Battered Babies

NEW YORK (Reuters Health) - Infants who suffer "nonaccidental" traumatic brain injury often show severe neurologic and mental consequences later on in life, according to a new report.

"Follow-up protocols are needed so that at discharge from hospital a care plan for the future can be given to the families and provided to the child protection and child welfare services," Dr. Karen M. Barlow from the University of Calgary in Alberta, Canada, told Reuters Health.

"In this way we can try to get the rehabilitation services for these children," she said.

Barlow and her colleagues investigated outcomes after brain injury in 25 infants, when the children were 5 years old on average.

About two thirds of the survivors had abnormal cognitive or neurologic function, the team reports in the medical journal Pediatrics. More than half the affected children had severe difficulties and were totally dependent, while the others had lesser degrees of impairment.

"The post-injury environment influences recovery from a brain injury -- early intervention therapies, stimulation at home, and prevention of further injuries could all lead to a better outcome," Barlow said.

However, "These interventions are often difficult to put into place as we rely on the caregivers to bring the children for follow-up," she explained.

"This is nearly always done where children are in adoptive or foster care...But when the children are with the non-abusing parent, these parents sometimes feel animosity to the medical profession and do not wish to keep returning to hospital."

Can anything be done? "It would be a great help to have some kind of legal requirement to ensure these children get the care they need," Barlow said.

SOURCE: Pediatrics, August 2005.