Shaken Baby Syndrome
Also known as: Whiplash - shaken infant
What is it?
This is a severe form of head injury caused by
violently shaking an infant or child. It usually occurs in
children younger than 2 years old, but may be seen in
children up to the age of 5. The violent shaking may
result in severe injuries to the infant including
permanent brain damage or death.
A baby's head is large and heavy in proportion to their
body. For this reason, when a baby is dropped or thrown,
he will tend to land on his head. There is space between
the brain and skull to allow for growth and development.
The baby's neck muscles and ligaments are weak and
underdeveloped. All of these factors make infants highly
vulnerable to whiplash forces.
When an infant or young toddler is shaken, the soft,
pliable skull is not yet strong enough to absorb much of
the force. The forces are thus transmitted to the brain,
which then rebounds against the skull causing bruising of
the brain (cerebral contusion), swelling, pressure, and
bleeding (intracerebral hemorrhage).
The large veins along the outside of the brain are also
vulnerable to tear with these injuries which can lead to
further bleeding, swelling, and increased pressure (subdural
hematoma). This can easily cause permanent, severe brain
damage or death.
Shaking an infant or small child may also cause
injuries to the neck and spine. Eye damage is very common
and may result in loss of vision (retinal hemorrhage).
What causes it?
Shaken Baby Syndrome is almost always caused by
non-accidental trauma (child abuse). It is caused by an
angry or frustrated parent or caregiver who shakes a baby
in response to persistent crying. Many times they do not
intend to harm the baby.
In rare instances this injury may be caused
accidentally by actions such as tossing the baby in the
air or jogging with a baby in a backpack. It does not
result from gentle bouncing or play.
What are the symptoms?
- Change in behavior, irritability
- Lethargy, sleepiness, or loss of consciousness
- Pale or bluish skin
- Vomiting
- Convulsions (seizures)
- Poor eating
- Not breathing (apnea)
There are usually no outward physical signs of trauma,
such as bruising, bleeding or swelling. Examination by an
ophthalmologist frequently reveals retinal hemorrhages.
How is it diagnosed?
A physician diagnoses Shaken Baby Syndrome through the
use of CT Scans and other tests. Call your health care
provider immediately if a child exhibits any of the above
signs or symptoms or it you suspect the child has
sustained this type of injury. Getting medical care as
soon as possible may save the child’s life and prevent
devastating complications from developing.
What is the treatment?
- For a severe head injury such as this, immediate
emergency treatment is necessary. Activate the EMS system
(call 911).
- DO NOT pick up the child or shake him to attempt to
wake him up.
- DO NOT attempt to give anything by mouth.
- If the victim stops breathing before emergency help
arrives, begin CPR.
- If the victim is vomiting and you don’t suspect a
spinal injury, turn his or her head to the side to
prevent choking and aspiration. If you suspect a spinal
injury, CAREFULLY roll the whole body to the side as one
unit (logrolling) while protecting the neck.
- If the victim has a convulsion, follow instructions
for seizure-first aid.
- Treatment in the hospital may include insertion of a
drain to relieve pressure inside of the brain,
administration of intravenous fluids and anti-seizure
medication if indicated.
Prevention
- NEVER shake a baby or child, whether in play
or in anger.
- Do not hold your baby during an argument.
- If you find yourself becoming annoyed or angry with
your baby, put him in the crib and leave the room. Try to
calm down. Call someone for support.
- Call a friend or relative to come and stay with the
child if you feel out of control.
- There are resources available such as a local crisis
hotline or child abuse hotline.
- Seek the help of a counselor and attend parenting
classes.
- Do not ignore the signs if you suspect child abuse in
your home or the home of someone you know.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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