JMIR Publications

ABSTRACT

Background:

Disciplining a child is a multidimensional aspect of parenting. Children's disciplinary practices may vary due to social, cultural, and geographical boundaries. Whereas, it has been found that child-shaking is alarmingly common around the world. In infants, it is mainly triggered by crying. A third of mothers are unaware of the hazardous outcomes related to brain injury and long-term impacts that may lead to severe functional damage, though this practice is not considered as a punishment for the child. As mothers are the basic caregivers, maternal depression is more likely connected to their attitude towards children. Besides, a lot of functional differences are associated with poor urban and rural motherhood.

Objective:

To explore caregivers’ shaking practices to discipline young children and the underlying factors behind this shaking behavior in poor urban and rural Bangladesh communities

Methods:

This is a cross-sectional study where we randomly interviewed 800 caregivers of admitted children [< 2 years] from the hospitals of icddr,b in urban Dhaka [n=520] and rural Matlab [n=280]. We collected detailed information on how they discipline their young children [index children], with particular emphasis particularly on child-shaking behavior through a questionnaire. This includes probable causes and common beliefs regarding shaking. Additionally, we collected information on families’ socio-economic status and maternal or caregivers’-depression. Need to add an analytical plan used during data analysis. To find out the association between socio-demographics and maternal factors a Spearman correlation was done for the analysis. Also, a sample t-test was conducted to compare the urban and rural behavior using SPSS.

Results:

“Child-shaking” was higher in poor communities of Dhaka than in rural Matlab [51% vs 21%; p<0.001]. Mothers, as primary caregivers, mostly practiced shaking behavior while disciplining their children [60%]. Median lifetime-shaking episodes in under-two-year-olds were 3 to 5 times. Crying and fussing were the main triggering factors [Dhaka 86% vs Matlab 100%] for shaking behavior, particularly in infants <6 months of age. About 48.6% of mothers in Dhaka and 25.6% in Matlab believed that shaking is harmless. Maternal depression in urban-poor communities was significantly correlated with their shaking practices.

Conclusions:

The overall high prevalence rates of shaking young children support the need for further studies to find out its causal relationship with future child development, particularly in developing country settings where poverty and other stressors are common. This will facilitate to development of an early childhood intervention program. Also, awareness programs among parents can be raised as we need to be conscious about our behavior towards our children. Clinical Trial: N/A