What is shaken baby syndrome (SBS)?

Shaken baby syndrome (SBS) is a type of brain injury that occurs when a baby or a toddler is shaken violently. This causes swelling, bruising and bleeding in the brain. The child may be further injured if he or she is thrown down onto a surface, which is known as shaken impact syndrome.

Infants’ heads are very large and heavy in proportion to the rest of their bodies. When a child is shaken, his or her brain bounces back and forth against the sides of the skull. Shaking can cause bleeding in the brain (subdural hemorrhages, or hematomas) or in the retinas (retinal hemorrhages).

Why do people shake babies?

Parents or caregivers may shake a baby because it is crying for a long time, and they may think that shaking the baby will make him or her stop crying. Some parents or caregivers may be under stress for various reasons, and may become frustrated and unable to cope with the responsibilities of caring for a child. Other caregivers may simply not know that shaking a baby can be so dangerous.

Who shakes babies?

People who are most likely to shake a baby have a direct connection to the baby (father or mother) or an indirect connection (babysitter, secondary family members), and are both male and female. Shaken baby syndrome can happen among families of any ethnicity, any income range and with any type of family composition.

What are the symptoms of shaken baby syndrome (SBS)?

A child or baby who has been shaken and has had an injury to the brain may have symptoms such as:

  • 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
  • Bruises on the arms or chest
  • A large head or forehead
  • A soft spot on top of the head that is bulging
  • Inability to lift his or her head
  • Dilated (widened) pupils
  • Tremors (the shakes)
  • Inability to focus or follow movement with his or her eyes
  • Coma (unconsciousness)

Some symptoms show up right away, but others may not appear until later. Some children may have attention and behavior problems later in life from being shaken when they were infants.

Babies and children who are shaken face serious medical problems as they grow older, including:

  • Brain damage
  • Blindness
  • Hearing loss
  • Cerebral palsy
  • Speech and learning disorders, including mental retardation
  • Seizures
  • Neck and spinal cord damage, which can lead to problems with movement ranging from clumsiness to paralysis
  • Death

Who is most at risk for shaken baby syndrome (SBS)?

SBS happens most often in infants up to one year, with infants aged two to four months being most at risk. SBS 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.

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