Shaken Baby Syndrome
Shaken Baby Syndrome (SBS): Overview, Causes, Symptoms, and Prevention
What is Shaken Baby Syndrome?
Shaken Baby Syndrome (SBS), also known as abusive head trauma, is a severe brain injury that occurs when an infant or young child is violently shaken. The shaking causes the child’s brain to move back and forth within the skull, resulting in bruising, swelling, and bleeding in and around the brain. This can lead to permanent brain damage or death12369.
Causes and Risk Factors
- Primary Cause: SBS most often results from a frustrated or angry parent or caregiver violently shaking a baby, typically in response to inconsolable crying12356.
- Vulnerability: Infants are especially at risk because their neck muscles are weak, their heads are large and heavy relative to their bodies, and their brains are softer than adults’. This makes even a few seconds of shaking (as little as 5 seconds) extremely dangerous129.
- Not Caused By: Gentle play, bouncing a child on the knee, tossing in the air, or minor falls do not cause SBS15.
Symptoms and Signs
Symptoms can appear immediately or develop over hours. They may include2369:
- Difficulty breathing or apnea
- Poor feeding or vomiting
- Seizures
- Lethargy, irritability, or decreased alertness
- Unresponsiveness or coma
- Bruising (sometimes visible on the face or elsewhere)
- Swelling and bulging of the soft spot (fontanelle) on the head
- Poor muscle tone
- Unequal pupil size or abnormal eye movements
- In severe cases: shock, cardiovascular collapse, or death
Internal injuries may include:
- Brain bruising (contusion)
- Bleeding in the brain (subdural or subarachnoid hemorrhage)
- Retinal hemorrhages (bleeding in the eyes)
- Fractures of the ribs, skull, or other bones
- Spinal cord and neck injuries
Diagnosis
Diagnosis involves a combination of:
- Medical history and physical examination
- Imaging (CT scan, MRI) to detect brain injuries and bleeding45
- Skeletal surveys (multiple X-rays) to identify fractures4
- Eye examination to check for retinal hemorrhages4
- Blood tests to rule out other causes4
Treatment and Prognosis
- Immediate medical attention is critical. Treatment may include breathing support, surgery to relieve brain swelling or bleeding, and medications to prevent seizures and reduce swelling46.
- Prognosis: SBS often results in severe, lifelong disabilities such as cerebral palsy, blindness, hearing loss, developmental delay, or epilepsy. About 25% of affected infants die from their injuries6.
Prevention
- Education: Teach caregivers about the dangers of shaking and provide coping strategies for dealing with infant crying256.
- Support: Encourage caregivers to seek help if they feel overwhelmed. Never leave a baby with someone who may lose control56.
- Community Programs: Hospital-based parent education, well-baby visits, and home visits by health professionals can help reduce the incidence of SBS5.
Key Points
- SBS is a form of child abuse caused by violent shaking of infants or young children.
- Even brief shaking (as little as 5 seconds) can cause devastating, permanent injury or death.
- Symptoms may be subtle or severe, and immediate medical evaluation is essential.
- Prevention focuses on education, support for caregivers, and never shaking a baby for any reason.
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References:
1 NINDS
2 Vejthani Hospital
3 Mayo Clinic
4 Mayo Clinic (Diagnosis & Treatment)
5 CDC
6 Cleveland Clinic
7 StatPearls
8 National Center on Shaken Baby Syndrome
9 MedlinePlus
