Definition Shaken baby syndrome is a form of child abuse and involves repeated shaking of a young baby that results in a head or neck injury. This movement causes the brain to slam against the skull.
What are the signs and symptoms of the injury? Signs and symptoms of shaken baby syndrome include:
seizures
change in eating habits
change in behaviour
pale and bluish skin due to decreased blood flow
vomiting
A parent, relative or caregiver may cause the injury. Even someone who has very little contact with the baby may cause the injury. There are few outward signs of this type of injury. Many times an eye examination will show bleeding in the child's eye.
What are the causes and risks of the injury? In nearly all cases, shaken baby syndrome is caused by shaking the baby violently back and forth. A baby's head is much heavier than the rest of his or her body. The neck muscles are very weak. As the child develops, the neck muscles become stronger. Older children are better able to control the head so damage to the brain does not occur as easily. Shaken baby syndrome can cause permanent damage. It can lead to severe brain damage or even death. There can be major vision loss due to bleeding in the eyes.
What can be done to prevent the injury? To prevent shaken baby syndrome:
never shake a baby or child in either play or anger.
do not take anger out on a child. Seek help to control anger, if necessary.
call someone to come and assist with the child and take a time-out.
contact local authorities who can investigate the case if child abuse is suspected. If necessary, the child will be placed in protective custody away from the abusive situation.
How is the injury diagnosed? The diagnosis of shaken baby syndrome is usually made by an eye examination. This examination is done by a doctor or healthcare professional who is skilled at viewing the eye. A child who has been shaken will have bleeding in the eyes. This injury can also be diagnosed with the use of computerised tomography (CT) scan or by magnetic resonance imaging (MRI) of the brain. The CT or MRI may show damage to the brain, including bleeding and bruising.
What are the treatments for the injury? It is most important to remove the child from the abusive situation. This may require calling local authorities so that the child can be removed by the police or by healthcare officials. If the child has stopped breathing, cardiopulmonary resuscitation (CPR) should be started. When performing first aid alone, a person should shout for help, then begin first aid. If possible, have someone call for medical assistance. Once the child has been placed in a safe situation, a number of people will be involved in the care of the child. Care from doctors, nurses and therapists will be necessary to treat damage to the eyes and brain.
Many people are afraid to call the appropriate authorities when they suspect child abuse. A child may have no one else to help him or her. If abuse is happening, it could be too late once healthcare personnel are actually notified.
What are the side effects of the treatments? There are few side effects of treatment. Many people are afraid to notify the authorities if they suspect child abuse, which is the biggest risk to an infant who is being abused. If authorities are not notified in time, the child may suffer permanent disability or even die.
What happens after treatment for the injury? If a child has suffered shaken baby syndrome, the child will be placed in protective custody away from the abuser. If a parent is the abuser, the child could be placed in a foster home.
There could be several long-term effects caused by brain and eye damage. These children will need long-term follow up for these injuries. Law enforcement will be involved if the abuser can be identified. Shaken baby syndrome and child abuse are not related to any particular income level or ethnic group.
Author: James Broomfield, MD Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
