Q&A: Shaken baby syndrome

A "small number" of the so-called shaken baby convictions need to be re-examined by the courts, the Attorney General Lord Goldsmith has said. But what are the issues surrounding this controversial subject?

The review was delayed for judgement on four test cases

Q: What is shaken baby syndrome?

There is no single, agreed definition for the term.

Broadly speaking, it is used to refer to non-accidental injury of a baby as the result of violent shaking.

If the baby is found to have a particular set of internal injuries then SBS will be considered as a possible cause - as it is thought the force needed to sustain those injuries is so great they cannot result from normal treatment.

Some argue that the injury must include impact of the head, though whether this might include impact with the baby's own chest or back rather than an external object is also questioned.

Medical causes of death which are most common in cases of SBS are subdural bleeding (bleeding beneath the top layer of the brain), retinal haemorrhaging (bleeding behind the eyes) and axonal injury (shearing or severing the brain's nerve fibres).

Q: Why is it contentious?

The main logic behind shaken baby syndrome is that for a baby to sustain these type of injury, he or she must have been shaken with such considerable force that the injuries must be the result of violence.

However, research published in the past four years has suggested that some of these injuries, such as subdural haematoma, could instead be the result of a lack of oxygen resulting from a much less severe trauma, or possibly no trauma at all.

The most prominent proponents of this school of thought are Professor Helen Whitwell, head of forensic pathology at the University of Sheffield, and Dr Jennian Geddes, consultant neuropathologist at the Royal London Hospital.

This research has not been accepted as definitive by the medical community and there has been some strong criticism of the researchers' methods, but it has been sufficiently influential to raise doubts about convictions involving judgements of SBS.

Q: How are SBS cases related to sudden infant death cases?

In some ways these two sets of cases are quite different: in SIDs cases the cause of death is often unclear or unknown whereas in SBS cases the medical cause of death is known.

But the two phenomena are linked by an increasing medical controversy about the identification of the cause of the baby's injuries.

Q: What has led to the review of cases?

In January 2004, the attorney general ordered a review of all cases in the past 10 years which had involved convictions for killing infants aged under two.

The move followed the overturning of Angela Cannings' convictions for killing her two sons. Her case involved sudden infant death, not shaken baby syndrome.

The Cannings case was one of several which raised concerns that many parents convicted of killing their children were victims of miscarriages of justice.

Mrs Cannings was cleared after judges ruled that no-one should be prosecuted solely on the basis of medical opinion which was disputed between experts.

Of the 297 baby death cases reviewed, in 88 cases the cause of death was attributed to so-called baby death syndrome and these have been undergoing a separate review since July 2005.

This review was delayed pending a Court of Appeal judgement on four test cases. The court quashed two convictions, reduced one and dismissed a fourth appeal. It said not all shaken baby convictions were unsafe.

Q: What will happen to the cases to be re-examined?

These cases will be sent directly to the Criminal Cases Review Commission and then on to the Court of Appeal.

The Court of Appeal will consider whether the defendants convictions will be quashed.