Shaken Baby Syndrome


Shaken baby syndrome is a brain injury that happens as a result of forceful shaking of an infant or toddler. Learn the causes, symptoms and ways to prevent it.


What is Shaken baby syndrome?

Shaken baby syndrome is a serious form of brain injury that is due to violent and forceful shaking of a baby. The other names of this syndrome include abusive head trauma, shaken impact syndrome, and whiplash shake syndrome. This syndrome can destroy a baby’s brain cells and interrupts the supply of oxygen to the brain. It is a very serious form of child abuse inflicted upon a child and can even result in permanent brain damage or death. The damage can happen even from five seconds of shaking.

This syndrome is common in children under the age of two, but it can affect toddlers up to 5 years of age. Most cases of shaken baby syndrome are reported in infants during 6 to 8 weeks of age, the phase babies tend to cry the most. It is estimated by the National Center on Shaken Baby Syndrome that there are approximately 600 to 1400 cases of this syndrome in the United States per year.

Causes

Shaken baby syndrome happens when a parent or caregiver forcefully and violently shakes a baby out of frustration and anger. Nothing happens during bouncing a child on your knees, minor falls or rough play.

Babies have soft brains and very delicate blood vessels. Their weak neck muscles cannot fully support their proportionately large heads. Shaking a baby can cause their fragile brain to move back and forth inside of the skull. This violent force can trigger bruising in the brain, bleeding in the brain, brain swelling and damage to the brain cells.  Some of the other forms of injuries include broken bones as well as damage to the baby’s eyes, spine, and neck.

Symptoms

You may not observe any physical injury to the child’s body. A child may appear to be normal during mild forms of the syndrome. But over the course of time (within 4 to 6 hours) may develop health and behavioral problems. The following signs and symptoms can be seen.

  • Altered level of consciousness
  • Extreme fussiness or irritability
  • Dilated pupils that do not respond to light
  • Breathing problems
  • Abnormally slow and shallow respiration
  • Poor eating
  • Vomiting
  • Pale or bluish skin
  • Convulsions or seizures
  • Posture in which the head is bent back and the back arched
  • Paralysis
  • Coma

Upon medical examination, retinal hemorrhages, head injury bleeding, abdominal injury, bruises to the face, scalp, arms, abdomen or back can be noticed.


Diagnosis

Three main conditions of the syndrome are evaluated, which includes encephalopathy, subdural hemorrhage and retinal hemorrhage. Shaken baby syndrome affects multiple parts of the body and the following medical investigations will be carried out.

MRI: Detailed images of a child’s brain will be studied. Brain bruising, bleeding and signs of decreased oxygen are identified.

CT scan: Cross sectional images of the brain are revealed in this CT scan.

Skeletal x-ray: To reveal spine, rib, and skull fractures a skeletal x-ray will be performed.

Eye examination: A complete eye examination to detect eye injuries and bleeding.

Blood tests: Certain metabolic and genetic disorders (Osteogenesis imperfecta) exhibit symptoms similar to shaken baby syndrome. To rule out those, blood tests will be performed.

Treatment

If you suspect that your child had a shaken baby syndrome, call the local emergency and immediately proceed to the hospital. Some babies may stop breathing after shaking. In such cases perform a CPR.

It is important to keep in mind that you must not pick up the baby and give them food and water.

There is no particular medication for this syndrome. Performing a surgery to stop internal bleeding is the only option.

Complications

Irreversible brain damage can happen in few seconds. Many babies experience permanent vision loss, developmental and intellectual disabilities.

Prevention

Parents and caregivers may forcefully shake a baby due to reasons like stress, domestic violence, depression, single parenthood, alcohol abuse, unstable family situation and any history of mistreatment as a child. It is important that new parents and caregivers attend hospital based programs and learn to know how to handle a crying baby.

Crying is a normal way of communication for babies. Shaking can never be the right way of handling a baby. Always seek emotional support if you are unable to handle a fussy baby. 


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