Carenotes > Shaken Baby Syndrome

Shaken Baby Syndrome

GENERAL INFORMATION:

What is shaken baby syndrome? Shaken baby syndrome (SIN-drohm), or SBS, occurs when a baby develops brain injury as a result of physical abuse. This happens when a baby is grasped and shaken violently. A baby still has weak neck muscles and a large, heavy head. This makes it hard for him to control his head when he is shaken forcefully. Babies also have more fluid surrounding their brain. Intense shaking throws their brain back and forth inside the skull, and may cause it to bruise, swell, and bleed. This may lead to permanent, severe brain damage and even death.

Shaken baby injuries usually occur in children younger than two years of age. Sometimes, although rarely, it also happens to children up to five years of age. Men more than women are likely to shake a baby. The men are usually the baby's father or the mother's boyfriend. The women are mostly baby-sitters or child care providers. Shaking a child is a serious type of physical child abuse. Shaken baby syndrome may be a serious condition needing life-long medical treatments.

What causes shaken baby syndrome? The sudden forward and backward movements of a baby's head cause shaken baby syndrome. This occurs when a baby is forcefully and repeatedly shaken, or thrown down. Intense shaking throws the brain into different places inside the skull, tearing brain tissues and blood vessels. Injury to the brain then causes it to swell. Bleeding in the back of the eyes due to brain swelling is common. Many things may increase the chances of shaking a baby. Persons caring for a baby may get frustrated, frightened, or angry due to the baby's uncontrolled crying. They may shake the baby out of frustration, in a desire to stop the baby from crying.

What are the signs and symptoms of shaken baby syndrome? There may be few or no signs of injury in shaken baby syndrome. Symptoms may vary from mild to severe. These depend on how strong and how often the baby was shaken. Your baby may have any of the following symptoms:

• Mild to moderate:
  
  
  • Fussiness or uncontrolled crying.
    
    
  • Low body temperature.
    
    
  • Poor feeding or vomiting (throwing up).
    
    
  • Sleepiness or difficulty in waking your baby up.
    
    
  • Weakness or limp arms and legs.
  
  
• Severe:
  
  
  • Blood or blood spots in the eyes.
    
    
  • Bulging or full fontanels (soft spot on the head).
    
    
  • Coma (loss of consciousness).
    
    
  • Fractures (break in the bones).
    
    
  • Pale or bluish skin.
    
    
  • Seizures (convulsions).
    
    
  • Trouble or decreased breathing.

How is shaken baby syndrome diagnosed? Caregivers often look for particular injuries to diagnose SBS. These may include bleeding in the brain and eyes, and fractures of the ribs and bones. Your baby may have any of the following tests to look for these injuries:

• CT scan: This is also called a CAT scan. A special x-ray machine uses a computer to take pictures of your child's body. It may be used to look at your child's bones, muscles, brain, body organs, and blood vessels. Your child may be given dye by mouth or in an IV before the pictures are taken. The dye may help your child's caregiver see the pictures better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell the caregiver if your child is allergic to shellfish, or has other allergies or medical conditions.
  
  
• Lumbar puncture: This procedure may also be called a spinal tap. A small needle is placed into your child's lower back. Fluid will be removed from around your child's spinal cord and sent to the lab for tests. The test is done to check for bleeding around your child's brain and spinal cord, and for infection. This procedure may also be done to take pressure off your child's brain and spinal cord, or to give medicine. Your child may need to be held in place so that he does not move during the procedure.
  
  
• MRI: This test is called magnetic resonance imaging. During the MRI, 3-D (three-dimensional) pictures are taken of your child's body. An MRI may be used to look at your child's brain, muscles, joints, bones, or blood vessels. Your child will need to lie still during his MRI. Never enter the MRI room with an oxygen tank, wrist watch, or any other metal objects. This can cause serious injury.
  
  
• Ophthalmoscopy: This is also called fundoscopy. This test allows caregivers to see the back of the eye using an ophthalmoscope. An ophthalmoscope is a magnifying instrument with a light. Caregivers may use eye drops to dilate (open) the pupil (the dark center part of the eye). This helps caregivers see the back of your baby's eyes clearly.

How is shaken baby syndrome treated? Your baby's brain injuries may be life-threatening. He may need to stay in the hospital for treatments. Intravenous (IV) fluids may be given to control his body fluids and salts. A tube may be inserted into his stomach to empty the stomach or to get food into your baby's stomach.

A tube attached to a ventilator (breathing machine) may be used if your baby has trouble breathing. Medicines to decrease brain swelling and prevent seizures may be given. Shunt placements and surgery may be done in severe cases of brain injury. Ask your caregivers for more information about the different treatments that may be done to your baby.

What can I do to prevent shaken baby syndrome? Ask your baby's caregiver for more information on the normal growth and development of babies. This will help you better understand what your baby or child is trying to tell you.

• Crying is normal for a child. Babies do not cry to bother or get their parents or childcare provider mad. A baby cries for many reasons. He may be hungry, needs to have a diaper changed, or may be too cold or hot. Sometimes he cries just because he wants to be held. Crying may also be a way for your baby to release stress or tension. Crying may also tell you that your baby is hurt or sick.
  
  
• Decide carefully who can care for your child. Teach everyone who cares for your baby, including baby-sitters, about the dangers of shaking a child. Make sure they understand how babies normally act, and how they grow both mentally and physically.
  
  
• It is normal to feel upset and angry when your baby cries and cannot be consoled. Learning how to handle these feelings is important. Planning ahead may help you avoid hurting your baby. Call a friend or family member when you feel you are upset with your child. Post hotline numbers where you can see them and use them. Do the following if your baby is crying hard and cannot be consoled:
  
  
  • Stop: Put the baby in a safe place and leave the room. Do not touch the baby if you are very upset or angry.
    
    
  • Calm down: Play some soft music. When you get upset, call hotline numbers, a friend or another family member for advice and support. Take a shower, read a book, or think about something nice that happened in the past. Try counting to 10 and take a deep breath.
    
    
  • Try again: When you have calmed down, go back to your baby and try again to help him stop crying. Try putting the baby in a carrier, or take the baby for a walk in a stroller. You may also try and comfort him with his blanket.

Where can I get support and more information? You may feel scared, confused, guilty, and anxious because your baby has SBS. You may blame yourself and think you have done something wrong. These feelings are common. Talk to your caregivers, family, or friends about your feelings. You may also want to join a support group for shaken baby syndrome. Such a group can help you find community education and resources.

Put together a list of agencies, clinics, and caregiver names, addresses, and phone numbers. List all the people who will be involved with your child's long-term care and therapy. There are also federal, state, and local support services to help people with disabled children. Contact the following for support and more information:

• National Center on Shaken Baby Syndrome
  2955 Harrison Boulevard, Suite 102
  Ogden, UT 84403
  Phone: 1-801-627-3399
  Phone: 1-888-273-0071
  Web Address: http://www.dontshake.com
  

• The Shaken Baby Alliance
  4516 Boat Club Rd, Ste 114
  Ft. Worth, TX 76108
  Phone: 1-877-636-3727
  Web Address: http://www.shakenbaby.com
  

CARE AGREEMENT:

You have the right to help plan your baby's care. To help with this plan, you must learn about your baby's health condition and how it may be treated. You can then discuss treatment options with your baby's caregivers. Work with them to decide what care may be used to treat your baby.

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