Shaken Baby Syndrome

A victim of shaken baby syndrome may show any or all of the following signs and symptoms:

• bone fracture
• change in behavior
• coma
• decreased level of consciousness
• irritability
• loss of appetite, or poor feeding
• motor impairment
• pale and bluish skin due to decreased blood flow
• seizures
• vomiting

In nearly all cases, this syndrome is caused by shaking a baby violently back and forth. A baby's head is heavy in proportion to 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 occurs in all races, cultures, and socioeconomic groups. Males in their early 20's who are the baby's father or mother's significant other are most often identified as the perpetrator. Females who cause shaken baby syndrome are more often child care providers, rather than the child's mother.

Shaken baby syndrome usually occurs when a caregiver becomes angry and loses control.

Some steps to help avoid shaken baby syndrome include the following:

• 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.

Anyone who suspects child abuse should contact local authorities immediately. If necessary, the child can be placed in protective custody away from the abusive situation.

The diagnosis of shaken baby syndrome is usually made by a history and physical exam. An eye exam is part of the exam and is done by a healthcare professional who is skilled at viewing the inner eye. A child who has been shaken will often have bleeding in the back of the eyes. The healthcare professional may also order a cranial CT scan or cranial MRI. These special tests may show damage to the brain, including bleeding and bruising.

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 social services officials.

If the child has stopped breathing, cardiopulmonary resuscitation, also called 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 physicians, nurses, and therapists will be necessary to treat damage to the eyes and brain.

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.

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. Any new or worsening symptoms should be reported to the healthcare professional at once.