Shaken baby syndrome

Alternative names

Definition

Considerations

All of these factors make infants highly vulnerable to whiplash forces:

• A baby's head is large and heavy in proportion to his or her body. For this reason, when a baby is dropped or thrown, he or she will tend to land on his head.
• There is space between the brain and skull to allow for growth and development.
• Babies' neck muscles and ligaments are weak and not fully developed.
• An infant's skull is soft and pliable

When an infant or toddler is shaken, the skull is not yet strong enough to absorb much force. The force, therefore, is transmitted to the brain, which rebounds against the skull. This can cause bruising of the brain (cerebral contusion), swelling, pressure , and bleeding (intracerebral hemorrhage).

The large veins along the outside of the brain are also vulnerable and may tear with these injuries. Damage to these veins can lead to further bleeding, swelling, and increased pressure ( subdural hematoma ). This can easily cause permanent, severe brain damage or death.

Shaking an infant or small child may cause other injuries, such as damage to the neck, spine, and eyes. Eye damage is very common and may result in loss of vision (retinal hemorrhage).

Causes

Shaken baby syndrome is seldom an accident. The injuries are almost always caused by non-accidental trauma in other words, child abuse. An angry parent or caregiver may shake a baby to punish or quiet him or her. Many times they do not intend to harm the baby.

In rare instances, these types of injuries may be caused accidentally by actions such as tossing the baby in the air or jogging with the baby in a backpack. Shaken baby syndrome does not result from gentle bouncing or play.

Symptoms

• Change in behavior, irritability
• Lethargy , sleepiness
• Decreased alertness
• Loss of consciousness
• Pale or bluish skin (cyanosis)
• Vomiting
• Convulsions (seizures)
• Poor feeding
• Not breathing (apnea)

First Aid

• Call the local emergency number (such as 911). For a severe head injury such as this, immediate emergency treatment is necessary.
• If the child stops breathing before emergency help arrives, begin CPR.
• If the child is vomiting:
  • If you don't suspect a spinal injury, turn his or her head to the side to prevent choking and aspiration.
  • If you suspect a spinal injury, CAREFULLY roll the whole body to the side as one unit (logrolling) while protecting the neck to prevent choking and aspiration.
• If the child has a convulsion, follow instructions for seizure first aid .

Do Not

• DO NOT pick up or shake the child to attempt to wake him or her up.
• DO NOT attempt to give anything by mouth.

• A child exhibits any of the above signs or symptoms.
• You suspect a child has sustained this type of injury.

Prevention

• NEVER shake a baby or child, whether in play or in anger.
• Do not hold your baby during an argument.
• If you find yourself becoming annoyed or angry with your baby, put him in the crib and leave the room. Try to calm down. Call someone for support.
• Call a friend or relative to come and stay with the child if you feel out of control.
• There are resources available such as a local crisis hotline or child abuse hotline.
• Seek the help of a counselor and attend parenting classes.
• Do not ignore the signs if you suspect child abuse in your home or the home of someone you know.

Update Date: 10/30/2002