Shaken baby syndrome

Overview

Shaken baby syndrome is a serious brain injury that results from forcefully shaking an infant or a toddler. It also is known as abusive head trauma, shaken impact syndrome, inflicted head injury or whiplash shaken infant syndrome.

Shaken baby syndrome can damage or destroy a child's brain cells. This form of child abuse can cause permanent brain damage or death.

Shaken baby syndrome is preventable. Help is available for parents who are at risk of harming a child. Parents also can teach other caregivers about the dangers of shaken baby syndrome.

Symptoms

Symptoms of shaken baby syndrome may include:

• Extreme fussiness or irritability.
• Difficulty staying awake.
• Breathing problems.
• Poor eating.
• Vomiting.
• Pale or discolored skin.
• Seizures.
• Paralysis.
• Coma.

While sometimes a child may have bruising on the face, you may not see signs of physical injury to the child's outer body. Injuries that might not be seen immediately include:

• Bleeding in the brain and eyes.
• Spinal cord damage.
• Fractures of the ribs, skull, legs and other bones.

Children with shaken baby syndrome often show symptoms of prior child abuse.

In mild cases of shaken baby syndrome, children may appear OK after being shaken. But they may develop health or behavioral problems over time.

When to see a doctor

Seek help right away if you suspect your child has been injured by violent shaking. Call 911 or your local emergency number or take your child to the nearest emergency room. Getting medical care right away may save your child's life or prevent serious health problems.

Healthcare professionals are legally required to report all suspected cases of child abuse to state authorities.

Causes

Babies have weak neck muscles and can't support the weight of their heads. If a baby is forcefully shaken, their brain moves back and forth inside the skull. This causes bruising, swelling and bleeding.

Shaken baby syndrome usually occurs when a parent or caregiver severely shakes a baby or toddler due to frustration or anger. It often happens because the child won't stop crying.

Shaken baby syndrome is not caused by bouncing a child on your knee or minor falls.

Risk factors

These things may increase the risk that parents or caregivers might forcefully shake a baby and cause shaken baby syndrome:

• Having unrealistic expectations of babies.
• Having a baby that cries uncontrollably.
• Having a baby born prematurely or with medical needs.
• Being a young or single parent.
• Stress.
• Domestic violence.
• Alcohol or substance misuse.
• Unstable family situations.
• Depression.
• A history of mistreatment as a child.

Also, men are more likely to severely shake a baby hard enough to cause shaken baby syndrome than women are.

Complications

Even brief shaking of an infant can cause brain damage that can't be reversed. Many children affected by shaken baby syndrome die.

Children who survive shaken baby syndrome may require lifelong medical care for conditions such as:

• Partial or total blindness.
• Delayed development.
• Troubles with learning and behavior.
• Seizures or epilepsy.
• Cerebral palsy, a disorder that affects movement and muscle coordination.

Prevention

New parent education classes can help parents better understand the dangers of violent shaking. The classes also may provide tips to soothe a crying baby and manage stress.

When your crying baby can't be calmed, you may be tempted to try anything to get the tears to stop. But it's important to always treat your child gently. Nothing justifies shaking a child.

If you're having trouble managing your emotions or the stress of parenthood, seek help. Your child's healthcare professional may offer a referral to a counselor or other mental health professional.

If other people help take care of your child, make sure they know the dangers of shaken baby syndrome. These people might include a hired caregiver, sibling or grandparent.