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Facts about Shaken Baby Syndrome | Identification and Prevention

Shaken Baby Syndrome

Who and What?

Shaken baby syndrome is the term doctors use to describe the injuries that infants or young children incur when they are shaken. Shaken baby syndrome most commonly occurs as a result of two situations: it is either part of a pattern of abuse by a caregiver or a result of a caregiver’s momentary loss of good judgment from the frustration of having to respond to a crying baby.

The National Center on Shaken Baby Syndrome reports that doctors often misdiagnose shaken baby syndrome. They are generally slow to recognize the cause of the symptoms to be violent shaking and instead generally attribute them to other causes.

This unfortunate misdiagnosis occurs in part because victimized children do not usually present obvious external injuries such as bruises or cuts. The trauma that causes shaken baby syndrome occurs inside the child’s head and when doctors do not see injuries on the outside of the head, they often think that the brain trauma must have been caused by something internal to the child, not external to the child (like abuse).

For example, one study discovered that if a child was breathing normally, had no seizures, no head or face injury and came from married parents, doctors diagnosed shaken baby syndrome on less than 20% of visits.

How?

Shaking a baby or small child causes the brain to hit the inside of the skull and parts of the brain tear apart. This means that brain cells and blood vessels are torn and injured. Babies and small children are especially susceptible to injuries from shaking because their neck muscles are weak and undeveloped and their brain tissue is tender and fragile.

In addition to small children being vulnerable, the act of shaking is especially dangerous in comparison to other dangers. Children who are shaken violently as a result of anger or frustration experiences five to 10 times as much force on their brains as children who simply trip and fall. And that force is repeated each time the baby is shaken. It’s now easy to understand how important it is not to shake babies or small children.

Usually, outward injury from shaken baby syndrome is not visible or obvious because the injuries are almost always internal, particularly inside the head or behind the eyes.

Injuries can include:

  • Brain swelling and brain damage
  • Brain bleeding
  • Mental retardation or developmental problems
  • Blindness, hearing loss, paralysis, and speech and learning disabilities
  • Death

Shaken baby syndrome may have devastating effects for the family and the child. Most importantly, the child can die. If the child survives, medical bills can grow quickly to unbearable amounts. Injured children with brain damage such as mental retardation and cerebral palsy could need medical care for the rest of their lives, including institutionalization or other long-term care alternatives.

Why?

Shaken baby syndrome can occur for several reasons. Most incidents happen because a caregiver is frustrated or angry with a child. Most commonly this occurs when a child is crying and the caregiver shakes a child perhaps to make the child stop. This may in fact happen.

The National Center on Shaken Baby Syndrome reports that babies may stop crying as a result of the injury they sustained from the shaking. Unfortunately, the caregiver who shook the child may then think the child stopped crying because it was gratified, not because it was injured. If the caregiver believes this, the shaking is likely to be repeated and cause further injury.

Through public education, this misconception can be reduced and hopefully eliminated. Unfortunately, some caregivers have been told that shaking children should be used as a life-saving technique.

Until recently, some medical advice encouraged caregivers to shake children who had stopped breathing from sleep apnea. That advice has now been withdrawn, which is particularly important because parent of children who suffer from sleep apnea are generally stressed out and exhausted and are therefore more prone to physically abusing their children.

While less frequent, shaken baby syndrome can occur when a caregiver throws a child into the air too strongly. Some caregivers do not realize that they are playing too roughly with children or hitting infants too hard on their backs to make them cough. They are just not aware of the potential harmfulness of their actions.

What Can You Do?

Do not shake a child. Education is paramount. Anything you can do to inform people that shaking young children and infants can be deadly will help. Local organizations should provide information and programs focusing on such education. In addition, those organizations should provide assistance for parents to improve their coping skills and parenting techniques. Local human services departments should provide referral information and an anonymous abuse report hotline should be put in place.

If you are a caregiver and your patience is strained by the infants or children under your care, these tips will go far to sooth a crying child:

  • Pacifiers work well, but first make sure the baby is not crying from hunger or wetness.
  • Steady noises calm crying babies. Try a vacuum cleaner within hearing range, but not too close or loud.
  • Go for a walk or a car ride with the child
  • Watch the baby at all times while in a safe carrier on top of a running clothes dryer.
  • Gently hold and cuddle the child. Try a sling or front carrier that keeps the infant close to your body.

If you try all of these techniques and the child is still crying, make sure the child is not ill. If not, place the child on his or her side in a crib or other safe place. Take a break, take some deep breaths and relax. If you can ask someone to watch the child for a short period while you decompress.


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