What is Shaken Baby Syndrome & How is it Treated?

What is Shaken Baby Syndrome?

Shaken Baby Syndrome which is also known by the name of Abusive Head Trauma is a serious medical condition where a baby incurs a serious brain injury as a result of forcefully or violently shaking an infant or a newborn baby. Shaken Baby Syndrome is dangerous in that this condition completely destroys the brain cells of the baby and prevents the brain from getting enough oxygen. This condition is a very serious form of child abuse which may cause permanent disabilities to the child and even cause death due to Shaken Baby Syndrome.

Shaken Baby Syndrome is preventable in that it is important to educate the parents of the baby who have had a history of domestic violence in the past about the seriousness of the condition and keep the child away from any altercations so as to avoid harming the child. If the child is under the care of caregivers then they should also be educated to handle the child with lots of care and not to shake or move the baby aggressively or violently so as to avoid something like a Shaken Baby Syndrome.

What is Shaken Baby Syndrome?

What Causes Shaken Baby Syndrome?

As stated above, shaking a newborn baby violently or forcefully causes Shaken Baby Syndrome. This is because the neck muscles of the baby are very fragile and soft and is not in a position to support the head. Now if the baby is shaken forcefully or violently then the brain inside the skull also moves back and forth violently which may result in severe bruising, bleeding, swelling and even death of the cells within the brain in a matter of seconds.

Shaken Baby Syndrome is normally the result of anger and frustration of a parent if the child is irritable or crying inconsolably for any reason, especially at nighttime. This is mostly seen in parents who have a history of being short tempered, have a history of domestic violence in the past, or parents who just do not have the right education as to how tender an infant or a newborn child is.

What are the Symptoms of Shaken Baby Syndrome?

Some of the symptoms of Shaken Baby Syndrome are:

  • Extreme irritability
  • The baby has difficulty with staying awake
  • Baby has difficulty breathing
  • Poor eating
  • Tremors
  • Vomiting
  • The color of the baby’s skin may turn pale or blue
  • The baby may have seizures
  • The baby may have paralysis
  • The baby may go into a coma.

There may be other injuries that may also occur with Shaken Baby Syndrome which may not be seen initially and includes bleeding in the eye, damage to the spinal cord, and fractures of the ribs.

How is Shaken Baby Syndrome Diagnosed?

A child with suspected Shaken Baby Syndrome or having been shaken violently or forcefully needs emergent attention for a full proper diagnosis so that a treatment can be started as soon as possible. The child may need to be seen by a number of specialists before a confirmed diagnosis of Shaken Baby Syndrome is made. The child may have to go through a number of tests like:

CT/MRI Scan of the Brain: This will clearly show the interior of the brain and any damage done to the brain and other conditions like bleeding or fluid buildup can be easily seen through this scan. The scan may also help the doctor see the extent of the injury and formulate a treatment plan to treat the baby.

Skeletal Survey: This refers to a series of x-rays of the skeletal system which includes the hands, feet, legs, spine, and ribs so as to see if here has been any damage done to these areas of the body due to being shaken violently

Ophthalmological Exam: This child will also have to be seen by an ophthalmologist to look for evidence of any bleeding or other injuries to the eye to confirm the diagnosis of Shaken Baby Syndrome.

Once all these tests are done and a diagnosis of Shaken Baby Syndrome is confirmed the baby will be taken to the pediatric ICU for emergent treatment for Shaken Baby Syndrome.

How is Shaken Baby Syndrome Treated?

As soon as you suspect that the baby has suffered from Shaken Baby Syndrome or you come to know that the baby has been shaken violently ot forcefully then the first thing to do is to call 911 so that the baby’s treatment starts on an emergent basis. By the time the emergency personnel arrive you can do the following as initial treatment:

  • Put the baby on its back gently making sure that the neck and head does not get twisted
  • If the baby is less than one year of age then put one finger under the breastbone and if the baby is above one year of age then put your hand under the breast bone with the other hand on the forehead of the baby to tilt the head backwards. If a spinal cord injury is suspected then it is recommended hat the head of the baby is not tilted backwards. Make sure that the mouth of the baby does not close. Now perform chest compressions. Give at least 30 chest compressions without pausing. These compressions should be firm and fast.
  • After giving chest compressions check for the breathing pattern of the baby. If there is no breathing you can do a CPR and continue it till the medical personnel arrive and take the child to the hospital.

There are cases in which the child vomits after being shaken and in these cases there may be chances of the baby choking. To prevent this, gently roll the baby on to the side making sure that entire body of the baby is rolled and not just the neck area. Make sure not to give baby any food or water during this time so as not to complicate matter further due to Shaken Baby Syndrome.

As of treatment, there is no treatment for Shaken Baby Syndrome. Surgery may be done for cases where there is fluid build up in the brain to remove the excess blood and fluid from the brain. This may be done by placing a shunt. If there is evidence of bleeding from the eye then surgery may be done to remove the blood from the eye before it completely damages the vision of the baby permanently

What is the Prognosis of Shaken Baby Syndrome?

Shaken Baby Syndrome can result in brain damage in a matter of seconds which may be permanent. Many babies have complications from Shaken Baby Syndrome to include:

  • Permanent vision loss which may be total or partial
  • Permanent hearing loss
  • Seizures
  • Failing to meet developmental milestones
  • Intellectual disabilities
  • Cerebral palsy which can affect muscle coordination and speech.

Thus it is important to understand that newborns and infants are extremely sensitive and should be handled with care and parents much avoid incidents which may put their child in harm’s way due to something like a Shaken Baby Syndrome.

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:February 22, 2018

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