What is Shaken Baby Syndrome

Shaken baby syndrome is a type of abusive head trauma. It is a set of severe brain and eye injuries that occur when a young child is shaken vigorously or suffers blunt impact. The condition can lead to:

• Bleeding between the brain and skull (subdural hematoma).
• Brain damage.
• Mental disability.
• Loss of movement in the arms, legs, or other parts of the body.
• Uncontrollable shaking (convulsions or seizures).
• Vision impairment or blindness.
• Slowed development of mental, communication, and movement (motor) skills and slowed physical development.
• Delayed social and behavioral development.
• Muscle spasms.
• Cerebral palsy.
• Hearing loss.
• Death.

Shaken baby syndrome is a medical emergency and must be treated right away.

What are the causes?

This condition is caused by shaking a child out of anger or frustration, usually when the child will not stop crying. It is not caused by normal, playful interactions with a child. This usually happens when a parent or caregiver loses self-control.

Shaking a child causes the brain to bounce against the skull. The bouncing destroys brain cells and leads to bruising, swelling, and bleeding of the brain (intracerebral hemorrhage) or the eyes.

What increases the risk?

A child is more likely to get this injury if he or she:

• Is very young. Children from birth to age 5 are at risk for this condition. The condition most often occurs in the first year of life.
• Has a history of abuse and other injuries.
• Lives in an unstable household where the following are common:
  • Domestic violence.
  • Financial problems.
  • Drug abuse.

What are the signs or symptoms?

Symptoms of this condition include:

• Uncontrollable crying.
• Loss of consciousness.
• Having a hard time staying awake.
• Changes in behavior.
• Irritability.
• Difficulty breathing.
• Paleness or a blue or gray (ashen) color to the skin.
• Vomiting.
• Convulsions.
• Difficulty nursing or eating.
• Broken, injured, or out-of-joint (dislocated) bones.
• Injuries to the neck and spine.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.).

How is this diagnosed?

This condition is diagnosed based on:

• A physical exam.
• Blood tests.
• Imaging tests, such as:
  • X-rays.
  • CT scans.
  • MRI.

How is this treated?

Treatment for this condition depends on the severity and type of injury your child has. The main goal of treatment is to prevent complications and allow the brain time to heal. Treatment may include lifesaving measures such as:

• Close observation. This includes hospitalization with frequent physical exams.
• Breathing support. This may include using a ventilator.
• Procedures to stop any internal bleeding in the brain.
• Managing the pressure inside the brain (intracranial pressure or ICP) by:
  • Monitoring the ICP.
  • Giving medicines to decrease the ICP.
  • Positioning your child to decrease the ICP.
• Medicine to prevent seizures.

Follow these instructions at home:

Long-term care

It can be challenging to care for a child who has shaken baby syndrome. The effects of the trauma may not show up right away. The child may need extra help with things such as:

• Self-care.
• Education.
• Physical health and development.
• Mental health care.

You may not be able to give your baby the care that he or she needs by yourself. If it becomes too stressful, talk with someone and get help. Ask for help from friends, family, health care providers, and social services, if needed.

General instructions

• Give over-the-counter and prescription medicines only as told by your child’s health care provider.
• Do not give your child aspirin because of the association with Reye syndrome.
• If home physical therapy exercises have been prescribed, have your child do them as told by the child’s health care provider.
• Keep all follow-up visits as told by your child’s health care provider. This is important.

Get help right away if:

• You ever feel that you may shake your child.
• Your child:
  • Will not wake up.
  • Turns blue.
  • Has convulsions.
  • Starts vomiting.
  • Has a change in behavior.
  • Has bruises on his or her arms or neck.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.).

Summary

• Shaken baby syndrome is a type of abusive head trauma. It is a medical emergency and must be treated right away.
• The condition involves severe brain and eye injuries that occur when a young child is shaken vigorously or suffers blunt impact.
• Shaken baby syndrome usually happens when a parent or caregiver loses self-control and shakes a child out of anger or frustration.
• Get help right away if you ever feel that you may shake your child. Also, get help if your child will not wake up, turns blue, has convulsions, or starts to vomit.