Sir.—The article by Alexander et al1 that appeared in the January issue of AJDC is one of several in the recent pediatric and radiological literature demonstrating both the morbidity and mortality associated with the whiplash shaken infant syndrome (WLS) and the risk of repetitive injury. Unfortunately, neither the force needed to produce an acute injury nor the incidence of latent WLS resulting from clinically inapparent recurrent battery is known. Under these circumstances, parental education delineating the unique vulnerability of the cranial contents of young infants should be routine. Pediatricians and other medical personnel should listen for unasked questions and masked frustrations when parents discuss colic or other feeding problems, since these behaviors are antecedents in a significant proportion of cases of WLS.
The plea for an educational campaign is not new,2 and while such an effort may not avert the unfortunate outcomes discussed in the case reports,
KANDALL CL. Education Concerning Whiplash Shaken Infant Syndrome: An Unmet Need. Am J Dis Child. 1990;144(11):1180. doi:10.1001/archpedi.1990.02150350010005