Shaken Baby Syndrome

Shaken Baby Syndrome refers to the type of traumatic brain injury inflicted on a baby when he or she is forcefully shaken and occurs for the following reasons. As a baby's neck muscles are still not well developed and provides little support for their relatively large, heavy head, violent shaking causes the baby's head to rotate uncontrollably. This causes the fragile brain to bounce back and forth within the skull resulting in rupturing of blood vessels and nerves throughout the brain and tearing of the brain tissue. The end result is bruising, swelling, bleeding of the brain and increased pressure within the skull which can lead to permanent, severe brain damage or death.

Shaken Baby Syndrome is commoner than we think. In the United States alone, an estimated 1200 to 1400 cases of Shaken Baby Syndrome occur each year.

The initial symptoms of Shaken Baby Syndromes tend to be non-specific some of which are as follows:

• Poor feeding/eating
• Vomiting
• Lethargy
• Irritability
• Difficulty breathing
• Seizures
• Coma
• Cardiopulmonary arrest

At presentation, the medical team might pick up some of these additional signs:

• Decreased or increased muscle tone
• Pallor
• Retinal haemorrhages (blood pooling in eyes)
• Bulging or spongy anterior fontanelle
• Increased head circumference
• Presence of multiple bruises elsewhere on body
• Poor weight gain (failure to thrive)

It is important to see a doctor urgently if the child develops any of the above mentioned symptoms or if you suspect the child has been a victim of Shaken Baby Syndrome.

Early medical intervention may save the child's life but most affected children who survive tend to have permanent significant neurodisability.

Shaken Baby Syndrome is 100% preventable. It usually happens when a baby is crying inconsolably and the frustrated caregiver momentarily loses control.

The following strategies play an important role in prevention:

• Increasing awareness amongst caregivers of the potential dangers of shaking. It is best to advise caregivers not to shake a baby under any circumstances because gentle shaking can rapidly escalate.
• Educating caregivers about ways to soothe a crying baby and ways to alleviate their stress at the critical moments when a baby is crying.

Some tips:

• Holding the crying baby against your chest and gently massaging the baby
• Rock, walk or dance with the baby
• Be patient; take a deep breath and count to ten
• Lower any surrounding noise and lights
• Offer a pacifier or a noisy toy (shake it or rattle it)
• If you find yourself becoming annoyed or angry with the baby, put him or her in the crib and leave the room for a while. Try to calm down and call a relative or friend you can trust for support. You may want them to take over for a while whilst you have a rest.