Knitting for a cause: Purple baby caps signal normal crying patterns, aim to prevent Shaken Baby Syndrome

Using soft yarns in hues of purple, crafters can knit or crochet a message of support for babies born at two Spokane hospitals.

Part of a U.S. grassroots campaign organized by the National Center on Shaken Baby Syndrome, Click for Babies: Period of PURPLE Crying Caps brings awareness of Shaken Baby Syndrome, also called Abusive Head Trauma.

Locally, individuals are knitting the baby caps to donate for newborns at Providence Sacred Heart Medical Center and Children’s Hospital as well as at Providence Holy Family Hospital. The “click” in the campaign’s name refers to the clicking sound knitting needles make.

The hats are given out along with educational material intended to help new parents deal with the stresses of caring for newborns.

“Purple baby hats are given out by the hospital with a DVD and leaflet about babies who cry and never stop; it lets parents know they’re not alone,” said Sallee Johnson, 73, of Spokane. “It gives parents tips they can use.”

Johnson coordinates knitters at Harvard Park Retirement Community who made 301 caps donated in June to Holy Family. She said the South Hill facility had 14 people – residents, friends, and staff – who made the baby hats, the third year they’ve done so.

A baby cap can be in any shade of purple, even in the Spokane region’s favored lilac tone, and shoulde be at least 50 percent purple. Suggestions of knit or crochet patterns are online at clickforbabies.org.

About five years ago, the Providence hospitals in Spokane started using the Period of PURPLE Crying education program, said Kim Jorgensen, director of women and children’s services for both sites.

Parents get the DVD and handouts about the Period of PURPLE Crying, an acronym for increased crying typical in early infancy, which can peak at 2 months and end at 3 to 5 months.

The video-based program also emphasizes the importance of never shaking a baby, which can cause brain injury, vision problems, developmental delays, physical disabilities, hearing loss, or even death. Abusive head trauma is a leading cause of physical child abuse deaths in children under 5 in the U.S., according to Centers for Disease Control and Prevention.

The knitted or crocheted purple caps are meant to show community support for parents and babies, while offering a visual reminder about tips available through Period of PURPLE Crying. Parents at hospitals receive one purple baby cap with the program’s materials, if enough hats are available.

PURPLE stands for:

Peak, with babies crying more each week and the most at 2 months, then less at 3 to 5 months

Unexpected, as crying might come and go without people around them knowing why

Resists soothing, in that babies might not stop crying no matter what a parent tries

Pain, because babies might look like they’re in pain; even when they’re not

Long-lasting, since crying can last as much as five hours a day, or more

Evening, marking that babies might cry more in the late afternoon and evening.

Jorgensen said the campaign recently developed an app for iPhones and Android smartphones, which is free when the hospital provides a code. The app has the same DVD presentation but also information provided in five different languages, including Spanish and Russian.

Families can watch a short video with the PURPLE education through an in-hospital TV system, then parents are asked if they prefer the take-home DVD or the code for the app.

“We have them do that before they’re discharged, then we provide their baby with a purple hat and explain they’ve been donated, and they go along with the recommendations around the period of PURPLE crying,” Jorgensen added.

“When they’re given the purple hat, the nurses instruct them that this is a visual reminder for you to remember the period of PURPLE crying information, that the hat will remind you to either initiate what you’ve been taught or to go on your phone and review what steps you need to take to deal with your crying baby.

“We try to give the caps out as long as we have them, any time. Babies actually lose heat through their heads. Even if it’s summer, we put a hat on them.”

The Providence hospitals receive many in-kind donations, including handmade hats in various colors, throughout the year. In a given year, its Providence Health Care Foundation sees donations of between 3,000 to 5,000 knitted hats for newborns and pediatric patients.

The two Spokane facilities typically handle about 4,500 births in a year.

The foundation accepts in-kind donations at Sacred Heart Children’s Hospital, but people sometimes take them in person to Holy Family. More donated baby caps made in purple are always welcome, Jorgensen said.

Christine Baker, based at Seattle Children’s, is a statewide program coordinator for the Period of PURPLE Crying program and part of a state coalition to prevent Abusive Head Trauma.

She said the education program is based on 30 years of research about increased crying in an eight-week period, which typically decreases at about 3 to 4 months. Among pre-term and full-term infants, even babies in different cultures, the increased crying pattern is common, she said.

“What research showed looking at this normal developmental pattern of increased crying – people used to call it colic – if you take that and you overlay the number of cases of Abusive Head Trauma, or shaken baby, it’s almost the exact same curve,” Baker said.

“The connection was made that this increase in crying is the trigger for a parent or caregiver shaking a baby when frustrated or angry with the crying.”

The educational materials were developed to educate parents that the crying is normal, as are their feelings of frustration, even anger, she said. “You’re not a bad parent, you don’t have a bad baby, you’re not an incompetent parent, it’s a normal developmental phase,” she added.

“It provides some tools to soothe but also to normalize. It’s OK to be frustrated or even angry but the best thing to do is set the baby down in a safe place and walk away and take a break.”

The Click for Babies component helps get the word out to others in the community, she said, for a shift in public perceptions about crying babies and a move toward supporting parents rather than judging them, she said.

Some hospitals with fewer handmade hats give them to parents during cooler months of November and December, although the Period of PURPLE Crying materials are distributed year-round with or without the caps, Baker said.

The education campaign has been in Washington state since 2012, Baker said. Among 62 birthing hospitals in the state, 44 of those distribute Period of PURPLE Crying material, she said; other centers, including the Rockwood system now under MultiCare Health System, have indicated interest.

Washington state has 86,000 to 87,000 births per year, according to Baker.

“We did have to get some caps last year from another state; we were short,” Baker said. “At Seattle Children’s, last year we distributed 3,500 hats. They are always warmly welcomed and parents appreciate that someone made it for them.

“Parents feel so much pressure to do the right thing, and sometimes your baby just cries. That’s just normal. That’s one of the key take-aways, and that’s validating to parents.”