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Shaken Baby Syndrome

Considerations

Shaken baby syndrome can occur from as little as 5 seconds of shaking.

Shaken baby injuries most often occur in children younger than 2 years old, but may be seen in children up to 5 years old.

When an infant or toddler is shaken, the brain bounces back and forth against the skull. This can cause bruising of the brain (cerebral contusion), swelling, pressure, and bleeding in the brain. The large veins along the outside of the brain may tear, leading to further bleeding, swelling, and increased pressure. This can easily cause permanent brain damage or death.

Shaking an infant or small child may cause other injuries, such as damage to the neck, spine, and eyes.

Causes

In most cases, an angry parent or caregiver shakes the baby to punish or quiet the child. Such shaking most often takes place when the infant is crying inconsolably and the frustrated caregiver loses control. Many times the caregiver did not intend to harm the baby. Still, it is a form of child abuse.

Injuries are most likely to happen when the baby is shaken and then the baby's head hits something. Even hitting a soft object, such as a mattress or pillow, may be enough to injure newborns and small infants. Children's brains are softer, their neck muscles and ligaments are weak, and their heads are large and heavy in proportion to their bodies. The result is a type of whiplash, similar to what occurs in some auto accidents.

Shaken baby syndrome does not result from gentle bouncing, playful swinging or tossing the child in the air, or jogging with the child. It also is very unlikely to occur from accidents such as falling off chairs or down stairs, or accidentally being dropped from a caregiver's arms. Short falls may cause other types of head injuries, although these are often minor.

Symptoms

The symptoms can vary, ranging from mild to severe. They may include:

There may not be any physical signs of injury, such as bruising, bleeding, or swelling. In some cases, the condition can be difficult to diagnose and may not be found during an office visit. However, rib fractures are common and can be seen on x-rays.

An eye doctor may find bleeding behind the baby's eye or retinal detachment. There are, however, other causes of bleeding behind the eye and they should be ruled out before diagnosing shaken baby syndrome. Other factors must be considered.

 

Shaken baby symptoms

 

First Aid

Call 132 or your local emergency number. Immediate emergency treatment is necessary.

If the child stops breathing before emergency help arrives, begin CPR.

If the child is vomiting:

Do Not

When to Contact a Medical Professional

Call your health care provider if a child has any of the above signs or symptoms, regardless of how mild or severe they are. Also call if you think a child has shaken baby syndrome.

Prevention

References
  • Heegaard WG, Biros MH. Head injury. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Mosby; 2014:chap 41.
  • http://hendrick-medical.adam.com/content.aspx?productId=117&isArticleLink=false&pid=1&gid=007578 accessed on 18.04.2016

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Jane and I wanted to thank you so much for the care you and your colleagues took of Jane whist in Mauritius. Everything went well and Prakash did a great job of getting us to your clinic and back over the 6 dialysis days. We had a wonderful holiday and our children and grandchildren plus the other family all enjoyed it enormously. Best wishes to you all

Andrew and Jane Stewart
17.04.2017