Shaken Baby Syndrome
Shaken baby syndrome is caused by forcefully and violently shaking a baby. Other names for this condition include abusive head trauma, shaken impact syndrome, whiplash shake syndrome, and inflicted head injury. Shaken baby syndrome is a form of child abuse that causes severe brain damage. It can result from as few as five seconds of shaking.
Babies have soft brains and weak neck muscles. They also have delicate blood vessels. Shaking a baby or young child can cause his or her brain to repeatedly hit the inside of the skull. This impact can trigger bruising of the brain, bleeding in the brain, and brain swelling. Other injuries can include damage to a baby’s eyes, spine, and neck as well as broken bones.
Shaken baby syndrome is more common in children under the age of 2 but can occur in children as old as 5. Newborns and babies may sometimes fall off of a bed or down the stairs. These incidents rarely result in shaken baby syndrome. This condition does not result from bouncing a baby on the lap or playfully tossing a baby in the air. It is a serious and deliberate form of abuse.
If you believe that your baby or another baby is a victim of shaken baby syndrome, call 911 right away. This condition is life threatening and requires immediate medical attention.
Physical signs of abuse do not always occur with shaken baby syndrome. However, an X-ray or eye examination by a doctor may show signs of trauma. A doctor may detect rib fractures or notice bleeding behind a baby’s eyes.
If symptoms do appear with shaken baby syndrome, they may include:
- difficulty staying awake
- body tremors
- breathing difficulties
- poor eating habits
- discolored skin
- loss of vision
To diagnose shaken baby syndrome, a doctor will look for the three conditions that often indicate the syndrome. These are:
- brain swelling (encephalopathy)
- bleeding in the brain (subdural hemorrhage)
- bleeding in the part of the eye called the retina (retinal hemorrhage)
To make the diagnosis and check for signs of brain damage, a doctor will order a variety of tests. These tests may include:
- computed tomography (CT) scan (creates a cross-sectional image of your baby’s brain)
- magnetic resonance imaging (MRI) scan (uses powerful radio waves to create an image of your baby’s brain)
- skeletal survey (checks for spine, rib, and skull fractures using an X-ray)
- ophthalmological exam (checks for bleeding and eye injuries)
Some other medical conditions can mimic the symptoms of shaken baby syndrome. These include certain genetic disorders (such as osteogenesis imperfecta, which causes a baby’s bones to break easily) and bleeding disorders. Before confirming shaken baby syndrome, a doctor will order a blood test to rule out other causes.
If you suspect shaken baby syndrome, call 911 immediately. Some babies and children will stop breathing after being shaken. If this occurs, CPR can keep the child breathing while you wait for medical personnel to arrive.
The National Institutes of Health recommend the following steps to perform CPR:
- Carefully put the baby on his or her back. If you suspect a spinal injury, it is best if two people gently move the baby so the head and neck do not twist.
- Set up your position. Put two fingers on the middle of the breastbone (just below the nipples), and put your other hand on the baby’s forehead to keep the head tilted back. For a suspected spinal injury, pull the jaw forward instead of tilting the head, and do not let the mouth close.
- Perform chest compressions. Press down on the breastbone and push about halfway into the chest. Give 30 chest compressions without pausing while counting aloud. These should be fast and hard.
- Give rescue breaths. Check for breathing after the compressions. If there is none, tightly cover the baby’s mouth and nose with your mouth. Make sure the airway is open and give two breaths that last about one second each. The chest should rise.
- Continue CPR. Keep going with the cycle of 30 compressions and two breaths until help arrives. Be sure to keep checking for breathing.
Vomiting may also occur after being shaken. To prevent choking, gently roll the baby onto his or her side. Roll his or her entire body at the same time. If there is spinal cord injury, this method of rolling reduces the risk of further damage to the spine. It is important that you do not pick up the baby or give the baby food or water.
There is no medication to treat shaken baby syndrome. In severe cases, surgery may be required to treat bleeding in the brain. This may involve placement of a shunt (a thin tube) to drain excess blood and fluid and relieve pressure. Eye surgery may also be needed to remove blood before it permanently affects vision.
Irreversible brain damage from shaken baby syndrome can occur in a matter of seconds. Complications associated with shaking a baby include:
- permanent vision loss (partial or total)
- hearing loss
- seizure disorders
- cerebral palsy, a disability that involves problems with muscle coordination and speech
- learning delays
According to the Mayo Clinic, the death rate for shaken baby syndrome is 50 percent (Mayo Clinic).
Shaken baby syndrome is preventable. You can avoid harming your baby by never shaking him or her. If you’re angry or arguing with another person, do not hold your baby; you may accidentally shake your baby during an emotional outburst. If you feel yourself losing control, put your baby in his or her crib, and call a friend or family member for support. You can also receive guidance and help from a crisis hotline, such as the Boys Town National Hotline (1-800-448-3000), or a counselor.
If you have family members or other caregivers stay with your baby, be sure they are aware of the dangers of shaken baby syndrome.
If you suspect that a child is the victim of child abuse, do not ignore the problem. Call the local police or the Childhelp National Child Abuse Hotline: 1-800-4-A-CHILD.
Written by: Valencia Higuera
Published on Jul 05, 2012
Medically reviewed on Jul 05, 2012 by George Krucik, MD