Shaken Baby Syndrome
There are an estimated 1,400 cases of Shaken Baby Syndrome (SBS) which occur in the U.S. each year. Approximately 50 percent of children affected by SBS do not survive the abuse.
For those who do survive, the majority will require lifelong medical care for conditions such as developmental and intellectual disabilities, cerebral palsy, seizure disorders, partial or total blindness, hearing loss, developmental delays, or learning disabilities.
Shaken Baby Syndrome is a traumatic brain injury that occurs when an infant is forcefully shaken.
It is a form of child abuse that can result in permanent brain damage or death. The abuse destroys a child’s brain cells and prevents his or her brain from getting adequate oxygen.
SBS is preventable and help is available for any parent who is at risk of harming a child. Parents also can educate other caregivers about the dangers of shaking a child.
Signs and Symptoms
Various signs and symptoms of SBS exist. Any of the injuries listed below can lead to severe disability or death. If you believe a child has been shaken, seek medical help right away, as it could mean the difference between life and death.
Common symptoms include:
Extreme irritability, difficulty staying awake , breathing problems, decreased appetite or poor feeding, poor sucking or swallowing, head or forehead appears larger than usual or soft-spot on head appears to be bulging, tremors , vomiting for no apparent reason, inability to lift head, inability of eyes to focus or track movement or unequal size of pupils, pale or bluish skin, no smiling or vocalization, seizures, paralysis, coma.
The child could also receive other injuries that may not be noticeable, including bleeding in the brain and eye, damage to the spinal cord and neck, and fractures of the ribs, skull and bones.
In milder cases, a child could first appear to be normal after being shaken, but as time goes on he or she may develop health, learning or behavioral problems.
SBS most often occurs when a parent or caregiver severely shakes a baby in frustration or anger. This usually occurs because the child won’t stop crying. The parent reaches a breaking point and reacts violently. Contributing factors may also include sleep deprivation, poor coping skills, or anxiety.
Babies have weak neck muscles and struggle to support their heavy heads (a baby’s head makes up about 25 percent of his or her total body weight). If a baby is shaken with force, his or her brain moves back and forth inside the skull. This movement causes bruising, swelling and bleeding.
SBS is not caused by bouncing a child on your knee, minor falls, or even rough play. Most pediatricians would say there is a remote chance that a fall from less than 4 ½ feet high would cause a life-threatening head injury.
For parents and other caregivers, there are many factors that may increase the risk of inflicting Shaken Baby Syndrome. Some of these include:
Unrealistic expectations of babies
Alcoholism or other forms of substance abuse
Unstable family situations
A history of mistreatment as a child
In addition, men are more likely to cause Shaken Baby Syndrome than are women.
Tests and Diagnosis
A child who has been forcefully shaken may need to be examined by a number of medical specialists as well as an expert in child abuse. Various tests may be needed to detect injuries, including:
- Computerized tomography (CT) scan—This test uses X-ray images to provide cross-sectional images of a child's brain, which can help detect injuries that need urgent intervention.
- Magnetic resonance imaging (MRI)—This test uses a powerful magnetic field and radio waves to create detailed images of a child's brain. Due to the difficulty in performing this test on a child who is unstable, this is done usually two to three days after the injury.
- Skeletal survey—A series of skeletal X-rays (possibly including the arms, hands, legs, feet, spine, ribs and skull) may be used to tell whether fractures are accidental or purposeful and find previous fractures.
- Ophthalmic exam—An eye exam can reveal bleeding and other eye injuries.
SBS is preventable. When a baby cannot be calmed from crying, a parent or caregiver may be tempted to try anything to get the tears to stop. But it is extremely important to always treat the baby gently. If feeling anxious or stressed, hand the baby to a trusted partner or relative, and take a break. If alone, put the baby in a crib, walk away, count to 100, or do something that will help you calm down. Remember, if all the baby’s needs have been met, it is ok to let the baby cry.
It only takes a few seconds of shaking to cause irreversible brain damage. To see a video of what happens to a baby's brain after only one shake, click on the following link: Shaken Baby Simulator. If you are having trouble managing your emotions or the stress of parenthood, seek help. Share the dangers of Shaken Baby Syndrome to with anyone who takes care of your child, whether that is a hired caregiver, sibling or grandparent.
For more information, view the video produced by CBS: The Early Show on SBS entitled "Cause of Baby Death: Shaking."
If you need help or assistance, there are many resources available. The ParentLink WarmLine grants parents and professionals access to parenting information, support, problem-solving techniques, and nutrition information. Contact them at: 1-800-552-8522.
If you suspect child abuse in someone’s home, contact the Child Abuse & Neglect Hotline at: 1-800-392-3738.