What is shaken baby syndrome?

Shaken baby syndrome is a severe brain injury that occurs when an infant or young child is shaken violently. Exposure kills the child's brain cells and prevents oxygen from reaching the child's brain.

Shaken baby syndrome is a form of child abuse. When a child is vigorously shaken by the shoulders, arms, or legs, it can lead to learning disabilities, behavioral problems, vision problems or blindness, hearing and speech problems, seizures, cerebral palsy, severe brain damage, and permanent disability. In some cases, this can be fatal.

What shaken baby syndrome is not

Shaken baby syndrome is different from gently tossing a baby into the air or tossing a baby on your knee. Although their brains and necks are fragile, children are unlikely to be injured by falling off furniture or suddenly stopping in a car.

Symptoms of shaken baby syndrome

Shaking affects children in different ways. Symptoms include:

Vomiting
Bluish skin
Tremors or shakes
Breathing issues
Drowsiness
Less interest in eating
Trouble sucking
No more smiling or talking

You may notice bruising on the arms or chest where the child was grabbed. Other physical signs include:

A larger than usual head or forehead
Different-sized pupils
Not being able to focus
Favoring one arm or leg over another

Babies with shaken baby syndrome may also have symptoms that you cannot see, such as:

Broken ribs or other bones
Spinal cord or neck injury
Bleeding in the brain

In mild cases, behavioral, health, or learning problems appear later.

Causes of shaken baby syndrome

Babies take some time to raise their heads. This is because their neck muscles begin to weaken and strengthen as they grow. The same goes for their brain, which still needs time to develop.

When a baby is shaken, their brain can jump between the front and back of the skull. This causes bleeding, bruising and swelling. It only takes a few seconds of aggressive shaking.

Risk factors that lead to shaken baby syndrome

Babies bring a lot of joy, but there can also be moments of disappointment if you feel like you can't console their crying. Most caregivers handle this time very well. But if these feelings are overwhelming, it can cross the line. Certain things can increase the risk of crossing this line, including:

Alcohol or substance abuse
Unstable family situations
Depression

Diagnosis of shaken baby syndrome

Because shaken baby syndrome can affect many different aspects of a baby's health, more than one doctor or specialist may be involved in the diagnosis. Depending on the level of the child's injury, testing may be done in doctors' offices or in a pediatric intensive care unit.

To check the brain, doctors may use a CT scan to look for injuries that need immediate attention. Magnetic resonance imaging also shows doctors detailed regions of the brain.

X-rays of other parts of the body, such as the arms, legs, spine, and skull, show fractures and whether they were created by force or by accident.

Doctors may do an eye exam to check for eye damage and bleeding.

Some disorders can mimic the symptoms of shaken baby syndrome. To rule them out, doctors may order blood tests.

Treatment and prevention of shaken baby syndrome

Treatment for shaken baby syndrome depends on the injury. In emergency cases, surgery may be required. Some children will need care for the rest of their lives.

Shaken baby syndrome is 100% preventable. It all starts with making sure that all caregivers understand two things:

The dangers of shaking a baby, even for a few seconds.
That babies cry a lot at first.:

Peak pattern: At 2-3 months old, babies cry the most.
Unpredictable: Crying starts and stops without reason.
Resistant to soothing: Nothing stops the crying.
Pain-like look on face: When babies cry, they look like they're in pain, even if they're not.
Long bouts of crying: Babies can cry for hours at a time.
Evening crying: Some babies cry more in the afternoon and evening.

Sometimes you can stop crying by rubbing your baby's back, humming, using white noise from an app, or running water while walking or using a pacifier. Sometimes it seems like nothing is working. This is when you especially need to deal with your feelings.

Have a plan in place. If you feel like you're pushing yourself beyond your limits, put your baby on their back in a safe place and step back for a moment. Call someone you trust and they will listen to your frustration. During a conversation, check on your child every 5 to 10 minutes. You can also ask someone to watch your baby for half an hour while you walk around and take care of yourself.

If you notice that your caregiver or other parent is having trouble, support them and offer a safe place to take the child when they need a break. Like babies, sometimes parents and caregivers just need to cry and be comforted.