What Is Shaken Baby Syndrome?

Shaken baby syndrome is a serious brain injury caused by forcefully and violently shaking a baby. Other names for this condition include abusive head trauma, shaken impact syndrome, and whiplash shake syndrome. Shaken baby syndrome is a form of child abuse that causes severe brain damage. It can result from as little as five seconds of shaking.

Babies have soft brains and weak neck muscles. They also have delicate blood vessels. Shaking a baby or young child can cause their brain to repeatedly hit the inside of the skull. This impact can trigger bruising in the brain, bleeding in the brain, and brain swelling. Other injuries may include broken bones as well as damage to the baby’s eyes, spine, and neck.

Shaken baby syndrome is more common in children under age 2, but it can affect children up to age 5. Most cases of shaken baby syndrome occur among infants that are 6 to 8 weeks old, which is when babies tend to cry the most.

Playful interaction with an infant, such as bouncing the baby on the lap or tossing the baby up in the air, won’t cause the injuries associated with shaken baby syndrome. Instead, these injuries often happen when someone shakes the baby out of frustration or anger.

You should never shake a baby under any circumstances. Shaking a baby is a serious and deliberate form of abuse. Call 911 right away if you believe that your baby or another baby is a victim of shaken baby syndrome. This is a life-threatening condition that requires immediate medical treatment.

What Are the Symptoms of Shaken Baby Syndrome?

Symptoms of shaken baby syndrome may include:

  • difficulty staying awake
  • body tremors
  • trouble breathing
  • poor eating
  • vomiting
  • discolored skin
  • seizures
  • coma
  • paralysis

Call 911 or take your baby to the nearest emergency room immediately if they are experiencing symptoms of shaken baby syndrome. This type of injury is life threatening and can result in permanent brain damage.

What Causes Shaken Baby Syndrome?

Shaken baby syndrome occurs when someone violently shakes an infant or toddler. People may shake an infant out of frustration or anger, often because the child won’t stop crying. Although shaking does eventually make the baby stop crying, it’s usually because the shaking has damaged their brain.

Babies have weak neck muscles and often have difficulty supporting their heads. When an infant is forcefully shaken, their head moves uncontrollably. The violent movement repeatedly throws the baby’s brain against the inside of the skull, causing bruising, swelling, and bleeding.

How Is Shaken Baby Syndrome Diagnosed?

To make a diagnosis, the doctor will look for the three conditions that often indicate shaken baby syndrome. These are:

  • encephalopathy, or brain swelling
  • subdural hemorrhage, or bleeding in the brain
  • retinal hemorrhage, or bleeding in a part of the eye called the retina

The doctor will order a variety of tests to check for signs of brain damage and to help confirm the diagnosis. These tests may include:

  • MRI scan, which uses powerful magnets and radio waves to produce detailed images of the brain
  • CT scan, which creates clear, cross-sectional images of the brain
  • skeletal X-ray, which reveals spine, rib, and skull fractures
  • ophthalmic exam, which checks for eye injuries and bleeding in the eyes

Before confirming shaken baby syndrome, the doctor will order a blood test to rule out other potential causes. Some symptoms of shaken baby syndrome are similar to those of other conditions. These include bleeding disorders and certain genetic disorders, such as osteogenesis imperfecta. The blood test will determine whether or not another condition is causing your child’s symptoms.

How Is Shaken Baby Syndrome Treated?

Call 911 immediately if you suspect your child has shaken baby syndrome. Some babies will stop breathing after being shaken. If this occurs, CPR can keep your baby breathing while you wait for medical personnel to arrive.

The American Red Cross recommends the following steps to perform CPR:

  • Carefully put the baby on their back. If you suspect a spinal injury, it’s best if two people gently move the baby so the head and neck don’t twist.
  • Set up your position. If your infant is under age 1, put two fingers on the middle of the breastbone. If your child is over age 1, place one hand on the middle of the breastbone. Put your other hand on the baby’s forehead to keep the head tilted back. For a suspected spinal injury, pull the jaw forward instead of tilting the head, and don’t let the mouth close.
  • Perform chest compressions. Press down on the breastbone and push about halfway into the chest. Give 30 chest compressions without pausing while counting out loud. The compressions should be firm and fast.
  • Give rescue breaths. Check for breathing after the compressions. If there’s no sign of breathing, tightly cover the baby’s mouth and nose with your mouth. Make sure the airway is open and give two breaths. Each breath should last about one second to make the chest rise.
  • Continue CPR. Continue the cycle of 30 compressions and two rescue breaths until help arrives. Be sure to keep checking for breathing.

In some cases, the baby may vomit after being shaken. To prevent choking, gently roll the baby onto their side. Make sure to roll their entire body at the same time. If there’s a spinal cord injury, this method of rolling reduces the risk of further damage to the spine. It’s important that you don’t pick up the baby or give the baby food or water.

There’s no medication to treat shaken baby syndrome. In severe cases, surgery may be required to treat bleeding in the brain. This may involve placement of a shunt, or thin tube, to relieve pressure or to drain excess blood and fluid. Eye surgery may also be needed to remove any blood before it permanently affects vision.

Outlook for Children with Shaken Baby Syndrome

Irreversible brain damage from shaken baby syndrome can occur in a matter of seconds. Many babies experience complications, including:

  • permanent vision loss (partial or total)
  • hearing loss
  • seizure disorders
  • development delays
  • intellectual disabilities
  • cerebral palsy, a disorder that affects muscle coordination and speech

How Can Shaken Baby Syndrome Be Prevented?

Shaken baby syndrome is preventable. You can avoid harming your baby by not shaking them under any circumstances. It’s easy to become frustrated when you can’t get your baby to stop crying. However, crying is a normal behavior in infants, and shaking is never the right response.

It’s important to find ways to relieve your stress when your child cries for extended periods of time. Calling a family member or a friend for support can help when you feel yourself losing control. There are also some hospital-based programs that can teach you how to respond when infants cry and how to manage the stress of parenting. These programs can also help you identify and prevent the injuries associated with shaken baby syndrome. Make sure your family members and caregivers are also aware of the dangers of shaken baby syndrome.

If you suspect that a child is the victim of child abuse, do not ignore the problem. Call the local police or the Childhelp National Child Abuse Hotline: 1-800-4-A-CHILD.