Shaken Baby Syndrome

What is shaken baby syndrome ?

Shaken baby syndrome is a severe brain injury, caused by head trauma due to violent shaking of the baby.

Shaken baby syndrome is a combination of medical symptoms indicating subdural hematoma, retinal hemorrhage and brain swelling. In most of the cases, the condition does not show any visible external trauma.

Shaken baby syndrome is mostly fatal. A forceful shaking if a toddler destroys the brain cells of a baby and prevents the flow of blood and oxygen to the brain, which results in shaken baby syndrome. It is equivalent to child abuse which can cause permanent impairment of the brain and can cause death. Half of the cases of shaken baby syndrome eventually end in a fatality.

Shaken baby syndrome symptoms 

The following are some of the signs of shaken baby syndrome:

• Problems in breathing
• Poor feeding or eating
• Vomiting
• Tremors
• Extreme irritability
• Pale or bluish skin
• Difficulty in staying awake
• Paralysis
• Coma
• Seizures

Other injuries which can’t be noticed with naked eyes are bleeding in brain and in eye, damage of spinal cord and neck and fractures in ribs, bones and the skull.

Mild cases of shaken baby syndrome may appear very normal and not elicit severe symptoms, but over the passage of time one may find problems in health, behavior and in learning.

Some complications of shaken baby syndrome include the following:

• A senseless shaking of a child for few seconds can cause a permanent disability or even death of the child. About 50% of children affected by Shaken baby syndrome do not survive. The other half also suffer throughout their life from some or other deformities and impairments, such as:
  • Loss  of hearing
  • Intellectual defects, including mental retardation
  • Cerebral palsy
  • Partial or complete blindness
  • Learning problems and developmental delays
  • Seizure disorders

Causes of Shaken baby syndrome

Generally babies have a weak neck and muscles, and hence they find it difficult to support their heavy heads. Forceful shaking of the baby makes the fragile brain to violently move back and forth inside the skull violently, leading to swelling, bleeding and bruising of the brain.

Shaken baby syndrome occurs when the parents or a caretaker shakes the baby in anger and/or in frustration. Whatever may be reason, nothing justifies violent shaking of a baby.

Some of the factors which may increase the risk of causing shaken baby syndrome in children are listed below:

• Domestic violence
• Stress
• Single or young parenthood
• Unstable family environment or conditions
• Unrealistic expectations from babies
• Alcohol abuse or drug use/abuse
• A history of physical abuse as a child
• Depression
• The caregiver’s nature and behavior
• Men are more culpable to cause shaken baby syndrome than women

Tests and diagnosis of Shaken baby syndrome

A number of exams and tests needs to be taken for diagnosing the syndrome by experts. They are as discussed below:

• Ophthalmological examination: This eye test will reveal about the bleeding and other ocular injuries if any.
• Computerized tomography (CT) scan: A CT scan provides cross-sectional images of a child’s brain and helps to detect injuries which may need urgent treatment.
• Blood tests: Genetic and metabolic disorders, bleeding and clotting disorders may also mimic the shaken baby syndrome. As such, this test helps to confirm and rule out some of these conditions.
• Skeletal survey: X-rays of the hands, arms, spine, ribs, skull, legs, feet and other skeletal areas are taken to find out whether the fracture is caused due to accidents or due to intent
• Magnetic resonance imaging (MRI): Powerful magnetic field and radio waves are used in an MRI test to avail of detailed images of child’s brain.

Depending on the nature and the extent of injury, the treatment for the baby can be monitored.

 Shaken baby syndrome treatment

The emergency treatment for an infant affected by shaken baby syndrome may include life sustaining procedures such as:

• Surgery for stopping the bleeding
• Providing breath supporting systems
• Monitoring of intracranial pressure within the skull
• Draining of fluid from the cerebral ventricles and
• Draining of hematoma if it is present, etc.

One can prevent development of shaken baby syndrome in the following ways:

• Cultivate the habits of keeping cool in handling the babies, even when they cry continuously. Because a mental imbalance of few seconds can cost the life of a child or can cause a permanent impairment, disability and an irreversible brain damage to the infant.
• If necessary, one can get the help of a doctor or a counselor or a professional mental health provider.
• If you happen to leave the baby under the care of a care-taker, or with grand parents or relatives, then make sure that they clearly understand the implications and problems associated with shaken baby syndrome.