Shaken Baby Syndrome (SBS)
I. What is Shaken
Shaken Baby Syndrome (SBS) is the
medical term used to describe the violent shaking and resulting injuries
sustained. It is one of the leading forms of fatal
child child abuse. When a baby is vigorously shaken, the head is moved (or snapped)
back and forth. This whiplash motion can cause delicate veins inside the
head to rupture, and bleed. The brain actually bounces inside the skull
cavity, which bruises the brain tissue. Once the bleeding begins to
pool, it causes swelling and pressure. Bleeding occurs behind the eyes,
(retinal bleeding) which can cause blindness. When the blood vessels to
the brain are torn away, brain damage results. Once the brain cells are
damaged, they are never regenerated or replaced and cannot be repaired. In
addition, the swelling and pressure causes the brain to push and squeeze down on
the brainstem, which controls vital functions such as breathing and heartbeat.
If the swelling and pressure are not controlled, (usually through medications
and/or surgery) vital functions may stop and the child could die.
Almost 25% (one out of four) of babies
with SBS die. The death usually occurs within hours or days. It
occurs most often in infants under 6 months old, but can occur in children up to
age 3. Severe signs and symptoms of SBS include breathing problems,
seizures and unconsciousness. More moderate symptoms that indicate severe
shaking has occurred are inability to suck, eyes glassy or unfocused, grimacing
or twitching and lethargy. The milder symptoms are poor feeding, vomiting
irritability or poor sleeping.
The survivors often suffer from varying
degrees of cerebral palsy, paralysis, seizures, blindness, hearing loss, or
developmental delays. It could also cause speech difficulties, behavioral
problems or a vegetative state. About 15% of the victims may have no
How does it occur?
A baby's head and neck are
susceptible to head trauma because their heads are large and heavy (making up to
25% of their total body weight) and their neck muscles are not developed enough
to support the force of shaking. The brain tissue is also very fragile.
When a child is shaken in anger or frustration, the force is multiplied five or
ten times more than if the child had simply fallen or tripped.
Most of the time, Shaken Baby Syndrome
occurs when an angry or frustrated adult shakes a child that will not stop
crying. Inconsolable crying, whether from colic, illness, pain or just
plain fussiness is the number one reason that sparks shaking. Infant cry
most between the ages of 6 weeks and 4 months. Other incidents that
provoke SBS include trouble with toilet training or misbehavior such as
interrupting. The shaking may be intended to emphasize the disciplinary
measure. It is estimated that 25% - 50% of parents and caregivers are not
aware of the effects that shaking a baby can cause. Many experts believe
that, in most cases, no serious hare was intended - they just wanted to stop the
crying or the undesirable behavior. They loose control and don't stop and
The majority of the perpetrators of SBS
are male (70% or higher) and most of the time it is the baby's father, yet the
mother's boyfriend, male child-care provides or stepfathers are also
responsible. Female child-care providers make up about 17% while the
mothers are responsible in aobut 13% of the cases. The victims of Shaken
Baby Syndrome are boys 60% of the time.
What can be done to prevent Shaken Baby Syndrome?
Taking care of a child can be very
difficult work. The most effective way to prevent SBS is to educate
parents, child-care providers, baby sitters, family members and siblings of the
dangers of shaking a baby. Also being aware of the appropriate ways to
help a baby stop crying is helpful. Infants use crying to communicate
needs of sometimes relieve stress.
Babies are fragile.
Please don't shake a child.NEVER, NEVER SHAKE A BABY!
The more relaxed you remain, the easier it
will be to console the child. Babies are sensitive to the tensions around
them. Letting your frustrations turn to panic or anger can intensify the
infant's crying. When you are feeling stressed, do not pick up the baby
until you feel calm. You could sit down, close your eyes and count to 20.
Try taking slow, deep breaths. You may be better off asking for another caregiver to take over for a while.
"An ounce of prevention is worth a pound of cure"
Funding for prevention programs continues
to be limited although the benefits of prevention can fare outweigh the costs
for a surviving Shaken Baby Syndrome child over their lifetime. It is
estimated that just the initial hospitalization for a SBS child is $75,000 -
$95,000. This does not include continuing rehabilitation or medical
expenses incurred after the child goes home. Most of these costs are
absorbed by society through insurance, government assistance, and increase
special education costs.
The 1999 Texas Legislative session (Human
Resources Code Section 43.0421.b) mandated a new training requirement for
caregivers who provide care for children under 24 months old in day care
centers, group day care homes and registered family homes. The child-care
providers are required to receive annual training regarding
recognizing and preventing shaken baby
preventing sudden infant death
understanding early childhood brain
development. Also, before a new employee works with this age group,
they must have completed the training.
If you become aware of a situation where a
child has been shaken, make sure the child gets immediate medical attention.
The bleeding inside the brain needs to be treated as soon as possible.
A complimentary Shaken Baby Syndrome kit
with facts sheets and poster can be obtained from the Foundation for the
Prevention of Child Abuse/National Exchange Club by calling 1-800-924-2643.
Internet websites with additional
1. A possible outcome of Shaken Baby
Syndrome could include veins inside the head to to rupture and bleed.
2. Once brain cells are damaged in
may take months for them to repair themselves.
What percent of babies with SBS die.
4. Classify the following symptoms
according severity or not symptomatic:
S = severe, M = moderate,
L = milder, N = not a symptom
5. Long term problems of SBS could include paralysis,
blindness, behavioral problems and Parkinson's Disease
6. Most of the time, SBS occurs
when an angry or frustrated adult shakes a child that will not stop crying.