Dr. Jill Roberson has seen only a couple of shaken baby cases, but that's two too many.

"The neck muscles are not very strong in babies, so the head goes back and forth with quite a bit of force," says Roberson, who practices at Premier Pediatrics in Southern Pines. "You can see the broken blood vessels in the retina from the force of shaking, which can cause permanent brain damage if not death."

FirstHealth Moore Regional Hospital is one of the first hospitals in North Carolina to participate in a prevention program for shaken baby syndrome, and maternity nurses are sharing the program's message and materials with parents of babies born at the hospital.

Called "The Period of PURPLE Crying," the program describes the characteristics of crying in healthy infants in order to help parents and other caregivers understand the frustrating features of crying that can lead to shaking or abuse.

Dr. Christoph Diasio, of Sandhills Pediatrics in Southern Pines, describes the program as one of "anticipatory guidance" for parents and caregivers.

"There are going to be times when it's OK to put the baby down and walk away," he says. "It is what it is: Someone with a short fuse is not the one to watch the baby."

"The Period of PURPLE Crying" intervention was developed by Dr. Ron Barr, a professor of community child health research and developmental pediatrician at the University of British Columbia, and Marilyn Barr, founder and executive director of the National Center on Shaken Baby Syndrome. Both are collaborating with the North Carolina project.

The concept, which was created by Barr, uses the acronym PURPLE to describe normal infant crying: Peaks at 2 months of age and ends at 4 or 5 months; is Unexpected; Resists soothing; the child appears to be in Pain; is Long-lasting (two to five hours); and occurs more often in the Evening.

The use of the word "period" in the program's name tells parents that the experience of in-creased, frustrating crying is temporary and will end.

"We want parents to understand that this is a normal developmental thing," Diasio says. "If mom and dad need a time to calm down, that's a reasonable thing to do.

"We want to counsel parents that this can happen and make sure they have a plan to keep the baby safe."

Nationally, an estimated 1,200 to 1,400 children a year receive medical treatment after being shaken. About 25 percent of those children die, and 80 percent of survivors are left with some form of lifelong brain injury.

Experts in the field also believe that many other children are shaken but not hospitalized and may have mental handicaps or learning disabilities later as a result.

Program training and supplies for "The Period of PURPLE Crying" are provided by Keeping Babies Safe in North Carolina, a collaborative effort of the National Center on Shaken Baby Syndrome, the University of North Carolina Injury Prevention Research Center and the Center for Child and Family Health.

The information includes hospital and health care provider-based parent education, a 10-minute video and an 11-page booklet that parents can share with other caregivers such as family members and babysitters.

The information that is covered centers on the hazards of shaking as well as alternatives that caregivers can use when they feel they need to get away from a crying baby -- handing the baby off to another caregiver, for example, or going to another room while leaving the baby in its crib with the rails up for no longer than 15 minutes.

Keeping Babies Safe in North Carolina has received about $7 million from the Centers for Disease Control and Prevention, the Doris Duke Charitable Foundation and the Duke Endowment, and is led by a coalition of stakeholders from the National Center for Shaken Baby Syndrome, the University of British Columbia, and state and county agencies, service providers and nonprofit organizations.

The first step in the "Period of PURPLE Crying" process is for all 90 North Carolina hospitals that handle deliveries to share the materials and message with parents and other caregivers of infants. This way, the program will reach every parent of the 125,000-some babies born in the state each year.

The goal is to reduce shaken baby syndrome in North Carolina by 5 percent over the next five years.

"This is a neat thing, and North Carolina is leading the way," Diasio says.

Roberson says, "I hope that, (1) it lets parents know they are not alone, that this is all normal and everybody goes through this; (2) that it helps them cope and deal with the crying baby and; (3) that it prevents shaken baby syndrome."