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Even though we’d rather not think about it, shaken baby syndrome is a real danger and knowing about it isn’t just about being aware; it’s about understanding how serious it is, recognising the signs, and knowing what to do if you or someone else might be at risk of harming a baby out of frustration.
Being informed can help prevent this tragic outcome and keep babies safe.
Shaken Baby Syndrome (SBS) is a severe form of abusive head trauma inflicted on infants and young children. It occurs when a baby is forcefully shaken, causing the brain to move back and forth within the skull. This violent shaking can result in serious brain injury, including bleeding, swelling, and even death.
Babies are highly vulnerable to violent shaking because their brains are softer and have more water content than adults. Shaking a baby can cause brain damage by making the brain hit the skull, leading to cell death and decreased oxygen supply. Even brief shaking can result in brain bleeding, bruising, and swelling, causing serious and irreversible harm.
Shaken baby syndrome occurs when a baby is forcefully shaken, causing their head to jerk back and forth rapidly. This violent motion can lead to severe brain injury or even death.Â
According to the American Academy of Paediatrics, it’s important to note that everyday activities like rocking, bouncing, or swinging your baby gently do not cause this syndrome. Shaken baby syndrome is a form of child abuse and is more formally referred to as pediatric abusive head trauma (AHT).
According to the National Center on Shaken Baby Syndrome, each year in the U.S., there are an estimated 600 to 1,400 cases of shaken baby syndrome, making it the leading cause of child abuse fatalities in children under 5 years old in the country.Â
Moreover, because babies have underdeveloped neck muscles and relatively large heavy heads, shaking can cause their delicate brains to bounce back and forth within the skull. This can result in bruising, swelling, and bleeding, potentially leading to permanent and severe brain damage or even death.
Shaken baby syndrome is typically caused by violent shaking, hitting, or purposeful dropping of a baby or young child. This action can cause the child’s brain to shake within the skull, tearing blood vessels, nerves, and tissues, resulting in swelling, bruising, and bleeding in the brain.
While shaken baby syndrome can affect children of all ages, it typically occurs before they turn 1 year old. On average, infants with shaken baby syndrome are between 3 and 8 months old.
Children’s soft brains, weak ligaments, underdeveloped neck muscles, and large, heavy heads make them particularly susceptible to these injuries.Â
Shaken baby syndrome often occurs when overwhelmed caregivers, unable to manage a baby’s persistent crying, lose control and act out of frustration or anger. Though often unintentional, such actions still constitute a form of child abuse. Â
Another frequent cause of shaken baby syndrome is when the baby experiences a hard blow on the head.
Shaken baby syndrome doesn’t happen from gentle bouncing, playful swinging, tossing the child in the air, or jogging with them. It’s also highly unlikely to occur from accidents like falling off chairs or stairs or being accidentally dropped by a caregiver. Minor head injuries from shortfalls may occur but are different from shaken baby syndrome.
According to the CDC, several factors can heighten the risk of a person carrying out an action that causes harm to a baby. Â These include:Â
It’s hard to spot the signs of shaken baby syndrome because they might appear immediately or much later. Plus, many cases of shaken baby syndrome aren’t often reported.
Signs of shaken baby syndrome can differ based on how serious the injury is and may include:
In approximately 80% of cases, shaken baby syndrome results in long-term disabilities. It induces a traumatic brain injury, known as a closed-brain injury. While mild symptoms may resolve with time and medical attention, others can persist, impacting various aspects of life.
Around 25% of cases lead to the infant’s death, either shortly after the incident or sometime later.
The long-term effects of shaken baby syndrome include:
According to research, in some cases, traumatic brain injuries can result in epilepsy, which may not appear until years later.
To prevent shaken baby syndrome (SBS), parents and caregivers must recognise the risks associated with shaking a baby. Understanding the triggers and risk factors for abuse is also essential.
SBS often arises when caregivers react to persistent and inconsolable crying. If a parent or caregiver struggles to soothe a crying baby, they may consider implementing the following strategies:
If you feel overwhelmed by a crying baby, you might need to concentrate on calming yourself by taking the following steps:
Ask someone to come over and provide you with some time to rest.
If you’ve attempted different methods to soothe your baby and they won’t stop crying, consider the following steps:
Remember, it’s okay if you can’t always calm your baby’s cries—it’s neither your fault nor your baby’s fault. It’s perfectly normal for healthy babies to cry a lot, especially in their first 4 months of life. This period of increased crying is often called the period of PURPLE crying , as defined by the National Center for Shaken Baby Syndrome (NCSBS).
Let’s break down PURPLE:
While purple crying can be very challenging and stressful for parents, it is a normal developmental phase for many infants and typically resolves on its own. It is not usually a cause for concern. However, If you have any concerns about your baby’s crying or your ability to cope with it, talk to your pediatrician for guidance and support.
When diagnosing shaken baby syndrome (SBS), a doctor starts by gathering the baby’s medical history and examining their symptoms. A physical examination may follow this to identify any signs of injury.
The doctor may use brain imaging scans, such as MRI or CT scans, to further assess the extent of the damage.
If SBS is confirmed, immediate treatment is crucial. This often involves providing emergency care, including respiratory support, to maintain the baby’s vital functions.
In severe cases, surgery may be necessary to address any bleeding in the brain or internal bleeding. Treatment aims to stabilise the baby’s condition and prevent further harm while also addressing any complications resulting from the syndrome.
Sometimes, there are no visible signs of injury, making it hard for caregivers and healthcare providers to realise a baby has been shaken. Internal injuries might not appear immediately, so symptoms could be mistaken for a viral infection.
Determining the exact incidence of shaken baby syndrome (SBS) is challenging because reliable data collection methods are lacking. The National Center on Shaken Baby Syndrome estimates that there are between 600 to 1,400 cases of SBS each year in the United States.
Despite the uncertainty in the precise numbers, this form of abusive head trauma remains the leading cause of both death and long-term disability among infants and young children who are victims of child abuse.
The force needed to cause shaken baby syndrome is significant, making it highly improbable to occur accidentally. Everyday activities like gently bouncing your baby on your knee or taking them for a jog in a stroller do not generate the force necessary to cause this syndrome.
Symptoms of shaken baby syndrome may appear immediately after shaking the baby and usually peak within 4-6 hours afterwards.
Shaken baby syndrome primarily impacts infants under 1 year old, especially those aged between 2 and 8 months. While it’s rare in children over 2, cases have been reported in children as old as 6.
Sometimes, there are no visible signs of injury, making it hard for caregivers and healthcare providers to realise a baby has been shaken. Internal injuries might not appear immediately, so symptoms could be mistaken for a viral infection.
Determining the exact incidence of shaken baby syndrome (SBS) is challenging because reliable data collection methods are lacking. The National Center on Shaken Baby Syndrome estimates that there are between 600 to 1,400 cases of SBS each year in the United States.
Despite the uncertainty in the precise numbers, this form of abusive head trauma remains the leading cause of both death and long-term disability among infants and young children who are victims of child abuse.
The force needed to cause shaken baby syndrome is significant, making it highly improbable to occur accidentally. Everyday activities like gently bouncing your baby on your knee or taking them for a jog in a stroller do not generate the force necessary to cause this syndrome.
Symptoms of shaken baby syndrome may appear immediately after shaking the baby and usually peak within 4-6 hours afterwards.
Shaken baby syndrome primarily impacts infants under 1 year old, especially those aged between 2 and 8 months. While it’s rare in children over 2, cases have been reported in children as old as 6.
1. American Association of Neurological Surgeons: Shaken Baby Syndrome
2. Center for Disease Control And Prevention: Abusive Head Trauma
3. Center for Disease Control And Prevention: A Journalist Guide to Shaken Baby Syndrome: A preventable Tragedy
4. Cleveland Clinic: Shaken Baby Syndrome
5. KidsHealth: Abusive Head Trauma (Shaken Baby Syndrome)
6. Medline: Shaken Baby Syndrome
7. National Center on Shaken Baby Syndrome
8. National Center on Shaken Baby Syndrome.
9. National Institute of Health: Paediatric Abusive Head Trauma
10. National Institute of Health: Shaken Baby Syndrome
11. New York State Department of Health: Shaken Baby Syndrome
12. The Pan African Medical Journal: Parental awareness, knowledge, and attitude about shaken baby syndrome in Riyadh, Saudi Arabia: a cross-sectional study
13. Long-term outcome of the shaken baby syndrome and medicolegal consequences: a case report. Annals of Physical and Rehabilitation Medicine, 52(5), pp.436-447.
14. WebMD: Shaken Baby Syndrome
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