Shaken Baby Syndrome
Shaken Baby Syndrome (SBS) is a severe brain injury resulting from forceful shaking of an infant or a toddler and is also known as inflicted head injury, abusive head trauma, or shaken impact syndrome. In shaken baby syndrome, a child’s brain cells get destroyed and are unable to get enough oxygen or blood, which leads to permanent brain damage. Babies have weak neck muscles and proportionally large heads, making them more vulnerable to violent or sudden movements, resulting in severe and sometimes fatal brain injuries. It can be prevented by proper education of parents and caregivers in handling a baby.
Symptoms vary and may appear immediately after the baby’s shaking, and reach a peak within 4 to 6 hours. Symptoms of SBS include difficulty sleeping, body tremors, difficulty eating, skin discolouration and change in sleeping pattern. More severe symptoms include unresponsiveness, seizures, coma, difficulty breathing, and death.
The signs of a shaken baby syndrome child may include retinal haemorrhages, subdural haematoma, epidural haematoma, lacerations, concussions, contusions, soft tissue injuries, abdominal injuries, chest injuries, low blood pressure, and bruises to the face, scalp, arms, abdomen or back.
What are the Impacts?
Shaken baby syndrome, with or without deceleration of the head, can cause the following impacts:
• Subarachnoid Haemorrhage, which is bleeding between the brain and the arachnoid membranes, can result from shaken baby syndrome.
• Collection of blood between the brain and the dura mater, called subdural haematoma, can occur when the veins bridging the brain to the dura are stretched beyond their elasticity, causing tears and bleeding.
• There may be coup and countercoup injury when the brain gets struck by the inner surfaces of the skull bones.
• Violent motion to the brain may cause shearing off or breakage of nerve cell branches (axons) in the brain cortex.
• If the child stops breathing during shaking, lack of oxygen causes irreversible damage to the brain. When injured nerve cells release chemicals that add to oxygen deprivation, this causes even further brain damage.
• There may also be retinal haemorrhages ranging from a few scattered haemorrhages to extensive haemorrhages involving many retina layers.
• The impact of injury, when a baby is thrown against a hard surface, can cause skull and other bone fractures, including the ribs, collarbone, and limbs.
Suggested Diagnostic Studies and Risk Factors
After a child presents with shaken baby syndrome, the doctor will take a history, optic fundus exam, and may advise CT scan of the head, MRI in particular cases, lumbar puncture, skeletal surveys, nuclear scans, drug screening, and routine blood tests.
The risk factors which increase the risk of shaken baby syndrome may include young or single parenthood, domestic violence, child abuse, unstable family, stress, unrealistic expectations of babies, depression, and poor education or awareness.
How can it be prevented?
Parent education and awareness can help parents better understand the dangers of violent shaking and may provide tips to soothe a crying baby. Treating your child gently is essential because nothing justifies harshly treating such a little life. If they take care of your child, a caregiver, sibling, or a grandparent, make sure they know the dangers of shaken baby syndrome.