Shaken baby syndrome is a potentially fatal form of child abuse. It occurs when a baby is forcefully shaken leading to damage within the child’s skull. The syndrome rose to prominence during the trial of a au pair who was found guilty of shaking a baby to death. 75% of babies who suffer brain injuries from shaking will die or suffer permanent disability.
What is it?
It occurs when an infant is forcefully shaken, usually by the shoulders, causing the child’s head to flop back and forth. It is not an injury that occurs from casually playing with a child.
A baby’s head is large and heavy. It makes up about 25% of the infant’s total body weight. Its neck muscles are too weak to support such a disproportionately large head. The force of the head movement can tear blood vessels that bridge the brain and skull, because these are fragile and immature.
What happens when a baby is shaken?
When shaking occurs, the brain bounces within the skull cavity, bruising the brain tissue.
The brain swells, creating pressure and leading to bleeding at the back of the eye. This can cause blindness. Some blood vessels that feed the brain are torn, which leads to additional brain damage or abnormalities.
Blood collects inside the skull, creating more pressure. Immediate effects include seizures, lethargy, vomiting, and irritability, or in extreme cases, coma or even death.
Infants can also sustain eye injuries, such as detached retinas or retinal bleeding, from the violent shaking. Long-term effects include learning disabilities, physical disabilities, seizures and, in extreme cases, death.
Who is responsible for shaken baby syndrome?
The injuries are usually caused by parents or carers who have become frustrated by their inability to stop a baby who is crying constantly.
Adults who were victims of abuse themselves and have low frustration levels may be more likely to shake a baby to hush its crying. Typical victims of this abuse are infants with colic who will not stop crying.
Almost 80% of the perpetrators of the syndrome are male and more than 60% of the victims are male.
Shaken baby syndrome has been referred to as a hidden form of child abuse because doctors evaluating the baby often do not see outward signs of injury on the head or old fractures or burns that are common to abused children.
What are the signs that a baby has been shaken?
The most common complaints presented to a doctor in shaken baby cases are:
Decreased muscle tone;
A large head at four months.