What is shaken baby syndrome?

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. Shaken baby injuries usually occur in children younger than two years old but may be seen in children up to the age of five.

Symptoms

The characteristic injuries of shaken baby syndrome are subdural hemorrhages (bleeding in the brain), retinal hemorrhages (bleeding inside the eye), 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:

• Breathing problems
• Convulsions
• Extreme irritability
• Lethargy
• Poor feeding
• Vomiting and pale or bluish skin

Treatment

Emergency treatment for a baby who has been shaken usually includes life-sustaining measures, such as respiratory support and surgery, to stop internal bleeding and bleeding in the brain. Doctors may use brain scans, including MRI and CT scans, to make a more definite diagnosis.

Prognosis

In comparison with accidental traumatic brain injury in infants, shaken baby injuries have a much worse prognosis. Damage to the retina of the eye can cause blindness. The majority of infants who survive severe shaking will have some form of neurological or mental disability, such as cerebral palsy or mental retardation, which may not be fully apparent before six years of age. Children with shaken baby syndrome may require lifelong medical care.