Shaken Baby Syndrome: Overview and Key Points

Definition

• Shaken baby syndrome is a severe form of child abuse resulting from violently shaking an infant or child.
• It can occur from as little as 5 seconds of shaking.

Age Susceptibility

• Most common in children younger than 2 years old.
• Can also occur in children up to 5 years old.

Mechanism of Injury

• The brain bounces back and forth against the skull during shaking.
• Can cause bruising of the brain (cerebral contusion), swelling, pressure, and bleeding.
• Large veins along the brain may tear, leading to further complications.
• May cause permanent brain damage or death.
• Other potential injuries include damage to the neck, spine, and eyes.

Causes

• Often occurs when a caregiver loses control due to frustration, especially when trying to quiet an inconsolable baby.
• Most cases are accidental but still constitute child abuse.
• Injuries are more likely if the baby's head hits a surface afterward.

Symptoms

• Convulsions (seizures)
• Decreased alertness
• Extreme irritability or behavioral changes
• Lethargy, sleepiness, lack of smiling
• Loss of consciousness
• Loss of vision
• No breathing
• Pale or bluish skin
• Poor feeding or lack of appetite
• Vomiting

Diagnosis Challenges

• Physical signs (bruising, bleeding, swelling) may not always be present.
• Rib fractures are common and can be detected via x-rays.
• Eye examination may reveal bleeding or retinal detachment, though other causes must be considered.

Immediate Action

• Call 911 or local emergency services immediately.
• If breathing stops, begin CPR.
• Handle vomiting while considering spinal injury precautions.
• Do not shake or give anything orally to the child.

Prevention

• Never shake a child in anger or play.
• Avoid holding a child during an argument.
• If frustrated, place the baby in a safe place and take a break.
• Seek support from friends, family, hotlines, or counseling services.
• Be proactive in recognizing and reporting child abuse.

References

• Important texts and medical professionals contributing to the understanding and documentation of this condition include works by Carrasco, Wolford, Eichman, Dubowitz, Lane, and Duhaime.
• Reviewed and updated by Neil K. Kaneshiro, MD, and other medical directors.

Note: Always stay alert for symptoms of shaken baby syndrome and report any suspected abuse to appropriate authorities.