More than half the children who died as a result of child abuse and neglect in Virginia in the year ending June 30, 2013, didn't live to see their first birthday, according to the annual report of the Hampton Roads Child Fatality Review Team, released last month.

Twelve of the 33 deaths statewide occurred in Hampton Roads, and another four in the region are under review.

Drowning, asphyxiation, gunshot, and blunt force trauma all played their part. For the past two years, however, none have been attributed to Shaken Baby Syndrome, which took the life of Jared Patton in December 2009. Jared was 6 weeks old and sustained severe brain damage when he was shaken by his father. Jared required around-the-clock care — which his family provided — until he died almost three years later. His father is currently in jail on another charge involving shaking his infant daughter.

Thanks to the relentless resolve of Jared's grieving grandfather Steve Stowe, of Hampton, in 2012 the Virginia General Assembly passed a resolution to designate the third week in April as Shaken Baby Syndrome Awareness Week. As well as being a leading cause of death in infants, 80 percent of babies who survive shaking or abusive head trauma suffer permanent disability. This can include brain damage, blindness, hearing loss, cerebral palsy and death.

The legislature also required Social Services to make information on Shaken Baby Syndrome available to all child welfare programs, and the Joint Commission on Health Care ordered a study that determined the typical cost of care for such victims at around $1 million.

Both the Navy and Children's Hospital of the King's Daughters in Norfolk implemented campaigns to raise awareness. And Prevent Child Abuse Hampton Roads, a nonprofit devoted to advocating for the safety of children, purchased videos and placed them in physicians' offices, social services departments, hospitals and libraries to spread the word about the seriousness of Shaken Baby Syndrome.

The terminology is changing. "We are moving away from using the term "shaken baby" to using 'abusive head trauma,'" Betty Wade Coyle, author of the fatality review and executive director emeritus of Prevent Child Abuse, wrote in an email.

According to the report, eight of Hampton Roads' 12 victims died of blunt force trauma "and had been severely battered more than once." Half had had previous contact with Social Services, and five of the abusers had a criminal record. More children were victimized by their biological parents than in the past, while two died at the hands of a mother's partner. Most of the perpetrators were white and while more men were responsible for fatalities, more women than men were responsible for physical abuse, the report states.

The report also highlighted the numbers of preventable deaths, those investigated but determined to be "unfounded" in terms of neglect or abuse. It pegged 18 of those deaths to unsafe sleeping environments, such as soft bedding, being laid to sleep on the stomach, co-sleeping with an adult, or in infant swings or seats.

The review team made strong recommendations for teaching safe sleeping practices to all new parents, male and female caregivers, grandparents, siblings, baby sitters, day care providers, and medical personnel. It urged educating the public and professionals about safe swaddling techniques and collaboration with the Eastern Virginia Medical School/CHKD Safe Sleep Initiative.

Here are its tips for safe sleep practices:

• Place babies on their backs.

• Monitor infants regularly while they are sleeping. Do not put in closet or isolated place.

• Use a safety approved crib, empty of toys, bumper pads, soft blankets and pillows.

• Do not put to sleep on bean bag chairs, soft mattresses, infant seats and baby swings.

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