What is shaken baby syndrome (SBS)?
Shaken baby syndrome refers to a type of brain injury that happens when a
baby or a toddler is shaken violently. Shaking can cause bleeding in the brain (subdural
hemorrhages) or bleeding in the retinas (retinal hemorrhages). Additional injury
happens when the shaken baby is thrown down onto a surface, resulting in shaken
impact syndrome.
When a child is shaken, the brain bounces back and forth against the sides of
the skull. Infants’ heads are very large and heavy in proportion to the rest of
their bodies. This causes swelling, bruising, and bleeding in the brain.
The potential consequences of shaking babies or toddlers are extreme. They include:
- Brain damage
- Blindness
- Hearing loss
- Speech and learning disorders, including mental retardation
- Seizures
- Neck and spinal cord damage, which can lead to motor dysfunction ranging
in severity from clumsiness to paralysis
- Death
What are the symptoms of shaken baby syndrome?
A child or baby who has been shaken and has pressure on the brain may have
symptoms such as these:
- Extreme irritability
- Vomiting
- Poor appetite or feeding problems
- Breathing difficulties
- Convulsions (seizures)
- Lethargy (extreme tiredness, lack of movement, inability to stay awake)
- Pale- or blue-colored skin
- Bruising, such as grab marks, on the arms or chest
- A forehead that appears larger than usual, or a soft spot that seems to be bulging
- Inability to lift his or her head
- Tremors (the shakes)
- Inability to focus or follow movement with his or her eyes
- Unconsciousness
- Coma
Who is most at risk for shaken baby syndrome?
Shaken baby syndrome happens most often in infants up to one year, with
infants aged two to four months being most at risk. Shaken baby syndrome does
not usually happen after age two, but children as old as five or six can be
damaged in this way if the shaking is extremely violent.
Why do people shake babies?
Parents or caregivers may think that shaking a baby will make the baby stop
crying. Parents or caregivers may be unable to cope with the reality of caring
for a child and take their frustration out on the child. Some may not know that
the results of shaking can be as devastating as they really are. However,
shaking babies or children is never okay.
Who shakes babies?
Statistics indicate that two-thirds to three-fourths of the people found
guilty of shaking babies are male. While the age range is great, generally men
who shake babies are in their twenties.
It is not true that only males shake babies. Mothers and other female
caregivers have also been found to have shaken babies. SBS can happen among
families of any ethnicity, any income range, and with any type of family
composition.
How is shaken baby syndrome treated?
SBS should be treated immediately. Parents or caregivers need to take the
child for emergency medical attention as soon as they are aware that the baby
has been shaken. The adults should also tell the health care provider that the
baby has been shaken. Caregivers who are not telling the truth may say that the
child has fallen. Depending on the severity of the symptoms, children may
require treatment such as respiratory support or surgery to stop bleeding.
Some symptoms show up right away, but others may not show up until later.
Some children may experience attention problems and behavior problems later in
life due to being shaken when they were infants.
How is shaken baby syndrome diagnosed?
Health care providers do not always get the truth about whether or not
shaking was involved in an injury. Also, babies and very small children cannot
tell doctors or nurses what happened or what hurts. Many symptoms of SBS (such
as irritability, vomiting, or lethargy) are also common for minor conditions
like viral infections.
It has been suggested that doctors should use additional tests when a brain
injury appears possible. X-rays can show skull fractures and doctors may suggest
magnetic resonance imaging (MRI) tests or computed tomography (CT) scans.
Special attention should be given to evidence of retinal bleeding (bleeding at
the back of the eyes).
Is shaken baby syndrome preventable?
Yes. Do not shake babies or children, EVER.
What can parents or caregivers do when babies cry?
When truthful answers are given about shaking babies, the parent or
caregiver most often says that the shaking occurred when the baby was crying
inconsolably. There are some things that you can do to avoid the likelihood of
becoming angry and shaking the baby.
- First, check to make sure that nothing obvious is wrong with the child.
You should check to see if diapers are clean and if the baby is hungry or
cold. Make sure there is no sign of illness, such as fever or swelling. You
should also check that there is no situation that is causing pain, such as
diaper pins that have come loose, or threads or hair wrapped around a finger
or toe.
- If the baby's needs are met, try using noise. You can put on a radio, or
sing and talk to the baby. Sometimes babies like noises like vacuum cleaners
or clothes driers.
- Offer the baby a toy or pacifier.
- Take the baby or child for a ride in the car, appropriately secured in his
or her car seat.
- Try a swing.
- Ask someone else to take over for you for a period of time so you can have
a break and calm down. This person who may take over can be a friend, a
coworker, a neighbor, or a family member. It is very reasonable to ask for
help. Babies cry an estimated one to three hours per day.
- If no one else is available to take over for you, put the baby safely in
the crib and leave the room for ten minutes or so while you calm down.
Remember, crying won’t hurt babies, but shaking will.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 8/23/2007…#13779
