Shaken Baby Syndrome (SBS)

Shaken baby syndrome is a type of inflicted traumatic brain injury that happens when a baby is violently shaken.  A baby has weak neck muscles and a large, heavy head.  Shaking makes the fragile brain bounce back and forth inside the skull and causes bruising, swelling, and bleeding, which can lead to permanent, severe brain damage or death.  The characteristic injuries of shaken baby syndrome are subdural hemorrhages (bleeding in the brain), retinal hemorrhages (bleeding in the retina), damage to the spinal cord and neck, and fractures of the ribs and bones.  These injuries may not be immediately noticeable.  Symptoms of shaken baby syndrome include extreme irritability, lethargy, poor feeding, breathing problems, convulsions, vomiting, and pale or bluish skin.  Shaken baby injuries usually occur in children younger than 2 years old, but may be seen in children up to the age of 5.
(National Institute of Neurologic Disorders and Stroke, 2010)

What happens when a baby is shaken…

Often, a baby is shaken due to the anger, frustration or stress of the person immediately caring for the child. It is often when the baby will not stop crying, or when other issues related to feeding or toilet training are occuring.The National Center on Shaken Baby Syndrome provides a great resource explaining what all of the crying is about with babies. Click here to check it out.Shaking is dangerous to infants and young children because their heads are relatively large and heavy, making up 1/4 of their total body weight. Especially earlier on, their neck muscles do not have the strength to support the head fully. The brains are more immature and are more easily injured by the force of shaking. Also, the blood vessels that surround the brain are at a higher risk of tearing than those of an adult or older child would be. When a child is shaken the following can occur:
  • The brain rotates within the skull cavity, injuring or destroying brain tissue.
  • When shaking occurs, blood vessels feeding the brain can be torn, leading to bleeding around the brain.
  • Blood pools within the skull, sometimes creating more pressure within the skull and possibly causing additional brain damage.
  • Retinal (back of the eye) bleeding is very common.

Immediate Consequences:

-Breathing may stop or become compromised
-Extreme irritability
-Seizures
-Limp arms and legs or rigidity/posturing
-Decreased level of consciousness
-Vomiting or poor feeding
-Inability to suck or swallow
-Heart may stop
-Death

Long-Term Consequences:

-Learning disabilities
-Physical disabilities
-Visual disabilities or blindness
-Hearing impairment
-Speech disabilities
-Cerebral Palsy
-Seizures
-Behavior Disorders
-Cognitive impairment
-Death

Common Symptoms:

If you suspect that a baby has been shaken, these are some of the symptoms you may notice. Seek medical attention immediately as this could be the difference between life and death in a young child.
-Lethargy/decreased muscle tone
-Decreased appetite, poor feeding or vomiting for no apparent reason
-Grab-type bruises on arms or chest are rare
-Extreme irritability
-No smiling or vocalization
-Poor sucking or swallowing
-Rigidity or postureing
-Difficulty breathing
-Seizures
-Head or forehead appears larger than usual or soft-spot on head appears to be bulging
-inability to lift head
-Inability of eyes to focus or track movement or unequal size of pupils
This information and more can be found on the website for The National Center on Shaken Baby Syndrome, www.dontshake.org.