If a person violently shakes a baby, they may cause the infant to develop shaken baby syndrome (SBS). This is a severe brain injury that can cause the brain to swell and bleed. SBS can cause brain damage and death.

According to the Centers for Disease Control and Prevention (CDC), SBS is a type of pediatric abusive head trauma (AHT).

It often occurs when a parent or caregiver becomes frustrated or angry when a baby cries. The person then violently shakes the baby, which causes them to develop SBS.

This is a form of child abuse.

AHT is a leading cause of physical child abuse deaths in children under 5-years-old in the United States. The CDC also states that AHT makes up one-third of all child abuse deaths.

If a person has violently shaken a baby or witnesses someone shaking a baby, then they should contact a doctor immediately. This is because the child may require emergency, life-sustaining treatment.

This article will cover the causes, symptoms, and treatment for SBS. It also goes into detail about how to prevent it.

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The National Institute of Neurological Disorders and Stroke (NINDS) notes that babies have weak neck muscles and large, heavy heads relative to their size. This means they are less able to control their neck and head movements. They also have a relatively fragile brain.

If a person becomes angry or frustrated with the infant and violently shakes a baby, this can cause the brain to bounce back and forward inside the skull. This can cause the brain to become bruised and swollen, and may also cause subdural hemorrhages, which is bleeding in the brain.

If a child has SBS, it may lead to permanent and severe brain damage or even death. Up to 20% of children with SBS die within a few days or weeks.

Children that do survive often experience cognitive issues and clinical symptoms.

Which children are at risk?

SBS usually occurs in children younger than 2 years old. However, it can affect children up to 5 years old.

Babies that are newborn to 1 year old have the greatest risk of injury from shaking, particularly those aged 2–4 months.

The main characteristics of SBS are:

  • subdural hemorrhages
  • retinal hemorrhages, which is bleeding in the retina
  • damage to the spinal cord and neck
  • broken ribs and other bones

A person may not notice these injuries right away and may spot other symptoms first.

Common symptoms of SBS include:

  • problems breathing
  • extreme irritability
  • lethargy
  • vomiting
  • poor feeding
  • convulsions
  • pale or bluish skin

If a person violently shakes a baby, this can cause SBS. This is because the baby’s brain bounces back and forward inside the skull.

SBS most commonly occurs when a parent or caregiver violently shakes a baby due to extreme frustration or anger. Another common cause is a blunt impact to the baby’s head.

Is it possible to cause shaken baby syndrome accidentally?

The CDC notes that SBS is a form of abuse, not play.

Bouncing a child on the knee, minor falls, and even rough play do not cause SBS. However, these activities for a baby can still be risky.

According to the CDC, there are a number of factors that can increase the risk of a person carrying out an action that causes harm to a baby. These include:

  • having unrealistic expectations about raising a child
  • having unrealistic expectations about child development
  • having experienced abuse or neglect as a child
  • being the victim of domestic violence or witnessing domestic violence

Other potential risk factors may include:

  • a lack of childcare experience
  • single-parent families or young parents without support
  • a lack of prenatal care

There are a number of risk factors that increase a baby’s chances of being a victim of SBS. These include:

  • having a history of previous child abuse
  • being born prematurely
  • being born with a disability
  • being one of a multiple births
  • being less than 6 months of age
  • crying inconsolably or frequently

If a person violently shakes a baby, even briefly, then the baby may experience SBS. This can cause a variety of complications, including:

  • blindness and impaired vision
  • physical disabilities
  • hearing impairments
  • epilepsy
  • intellectual disability
  • cerebral palsy
  • seizures
  • spasticity

When diagnosing SBS, a doctor may ask about the baby’s medical history and symptoms. They may then carry out a physical exam to look for signs of injury.

A doctor may also use brain scans. These include MRI scans and CT scans.

If a baby has SBS, they may require emergency treatment. This often includes life-sustaining measures, including respiratory support.

A child may also require surgery to stop any bleeding in the brain or any other internal bleeding.

There are a number of steps that people can take to prevent SBS. It is important that parents and caregivers understand the dangers of shaking a baby. It is also important for people to understand the triggers and risk factors for abuse.

SBS mostly occurs as a result of a caregiver’s reaction to continual and inconsolable crying. If a parent or caregiver cannot calm a crying baby, they may wish to try some of the following methods:

  • gently rock the baby
  • swaddle the baby in a blanket
  • offer the baby a pacifier
  • hold the baby close to their bare skin
  • sing or talk softly to the baby
  • take the baby for a walk in a stroller
  • take the baby for a drive in the car

It is also important that a parent or caregiver understands that infant crying is worse in the early months of the child’s life and that it will get better as the child grows.

They should also check for signs of illness if a baby will not stop crying and call the doctor if the child appears to be sick.

If a person is becoming frustrated

If a parent or caregiver is dealing with an inconsolable child and they feel they are becoming frustrated or upset, it is important that they focus on calming down.

They should put the baby down in a safe place and walk away to calm themselves. While they are calming themselves down, they should check on the baby every 5–10 minutes.

A person should never leave a baby with someone who is easily irritated, has a temper, or has a history of violence.

If a person finds themselves experiencing difficulties in caring for their baby, they should seek support. They should speak with a friend, relative, or the child’s healthcare professional.

For friends and family members of those caring for an infant

If a person is a friend or family member of a parent or caregiver, they should offer support to that person to help reduce the risk of SBS.

A person can offer support by:

  • offering to give the parent or caregiver a break if they need it
  • explaining that while caring for a crying baby can be frustrating, infant crying is normal and gets better over time
  • encouraging the person to put the baby in a safe place and take a calming break if they need it
  • being sensitive and supportive when speaking to a person who is dealing with a crying baby

If a person suspects child abuse

If a person suspects child abuse, they can contact 911. In addition, a person can contact their local child protective agency who can assess the situation and help take the appropriate action.

A person can find the contact information for their local child protective services here.

For more information on how to handle child abuse or neglect, a person can visit the Child Welfare Information Gateway.

If a parent or caregiver is struggling, they can contact charities and organizations for support. Some examples include:

  • Parents Helping Parents: A person can contact the Parent Stress Line at 1-800-632-8188. People can also look for support groups here.
  • National Parent Helpline: A person can look for resources in their state here.
  • Childhelp: Childhelp offer a free and confidential hotline for parents and caregivers experiencing stress. A person can call them at 1-800-422-4453 (1-800-4-A-CHILD). A person can find resources for parents here.

If a person is experiencing a mental health condition, they can also contact the Substance Abuse and Mental Health Services Administration here.

Q:

What advice would you give to someone who is afraid of asking for help for fear of repercussions?

Anonymous

A:

It is natural for someone who is having difficulty with caring for a child to worry about their child being taken away, but this is not the goal of the people and groups that help keep families safe. Helping to support parents so they can successfully raise their children is the top priority. The best time to reach out for help is before you are so overwhelmed and unsupported that you or a caregiver hurt your child. Asking for help can be hard, but taking the first step and talking with someone about your fears can go a long way to making everything seem more manageable.

Karen Richardson Gill, MDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

It is important to remember that adjusting to parenthood can be stressful and overwhelming and that it is OK to ask for help.

There are many challenges a person may face after having a baby, such as:

  • lack of sleep
  • feeling highly emotional
  • changes in relationship dynamics with a partner
  • feeling unable to bond with the infant
  • having an infant that will not settle

All of the above can lead to high stress levels and a lack of patience.

It is also important to note that postpartum depression can cause a person to have thoughts relating to harming themselves or their baby.

For any reason, people should seek help as soon as possible if they are experiencing thoughts about harming themselves or the child.

SBS is a form of child abuse. It occurs when a parent or caregiver violently shakes a baby or applies blunt force to the head.

This can cause the baby’s brain to bounce back and forward inside the skull. SBS can cause bleeding in the brain, bleeding in the eyes, broken bones, and damage to the spinal cord and neck.

Parents or caregivers may shake their baby due to extreme frustration or anger due to a baby that is inconsolable when crying.

Symptoms of SBS include extreme irritability, lethargy, poor feeding, problems breathing, convulsions, vomiting, and pale or bluish skin.

SBS can be fatal. If a baby survives, it may cause a range of complications.

A parent can try different calming techniques to lower their risk of shaking a baby. If a parent finds themselves becoming frustrated when their baby cries, they should put the baby in a safe place and walk away to calm themselves down, checking on the baby every 5–10 minutes.