Overview

Shaken baby syndrome — also known as abusive head trauma, shaken impact syndrome, inflicted head injury or whiplash shake syndrome — is a serious brain injury resulting from forcefully shaking an infant or toddler.

Shaken baby syndrome destroys a child's brain cells and prevents his or her brain from getting enough oxygen. Shaken baby syndrome is a form of child abuse that can result in permanent brain damage or death.

Shaken baby syndrome is preventable. Help is available for parents who are at risk of harming a child. Parents also can educate other caregivers about the dangers of shaken baby syndrome.

Symptoms

Shaken baby syndrome symptoms and signs include:

  • Extreme fussiness or irritability
  • Difficulty staying awake
  • Breathing problems
  • Poor eating
  • Vomiting
  • Pale or bluish skin
  • Seizures
  • Paralysis
  • Coma

You may not see any signs of physical injury to the child's outer body. Sometimes, the face is bruised. Injuries that might not be immediately seen include bleeding in the brain and eyes, spinal cord damage, and fractures of the ribs, skull, legs and other bones. Many children with shaken baby syndrome show signs and symptoms of prior child abuse.

In mild cases of shaken baby syndrome, a child may appear normal after being shaken, but over time he or she may develop health or behavioral problems.

When to see a doctor

Seek immediate help if you suspect your child has been injured by violent shaking. Contact your child's doctor or take your child to the nearest emergency room. Getting medical care right away may save your child's life or prevent serious health problems.

Health care professionals are legally required to report all suspected cases of child abuse to state authorities.

Causes

Babies have weak neck muscles and often struggle to support their heavy heads. If a baby is forcefully shaken, his or her fragile brain moves back and forth inside the skull. This causes bruising, swelling and bleeding.

Shaken baby syndrome usually occurs when a parent or caregiver severely shakes a baby or toddler due to frustration or anger — often because the child won't stop crying.

Shaken baby syndrome isn't usually caused by bouncing a child on your knee, minor falls or even rough play.

Risk factors

The following things may make parents or caregivers more likely to forcefully shake a baby and cause shaken baby syndrome:

  • Unrealistic expectations of babies
  • Young or single parenthood
  • Stress
  • Domestic violence
  • Alcohol or substance abuse
  • Unstable family situations
  • Depression
  • A history of mistreatment as a child

Also, men are more likely to cause shaken baby syndrome than are women.

Complications

Even brief shaking of an infant can cause irreversible brain damage. Many children affected by shaken baby syndrome die.

Survivors of shaken baby syndrome may require lifelong medical care for conditions such as:

  • Partial or total blindness
  • Developmental delays, learning problems or behavior issues
  • Intellectual disability
  • Seizure disorders
  • Cerebral palsy

Prevention

New parent education classes can help parents better understand the dangers of violent shaking and may provide tips to soothe a crying baby and manage stress.

When your crying baby can't be calmed, you may be tempted to try anything to get the tears to stop — but it's important to always treat your child gently. Nothing justifies shaking a child.

If you're having trouble managing your emotions or the stress of parenthood, seek help. Your child's doctor may offer a referral to a counselor or other mental health provider.

If other people help take care of your child — whether a hired caregiver, sibling or grandparent — make sure they know the dangers of shaken baby syndrome.

Oct. 28, 2017
References
  1. Mian M, et al. Shaken baby syndrome: A review. Fetal and Pediatric Pathology, 2015;34:169.
  2. Dias MS, et al. Association of a postnatal parent education program for abusive head trauma with subsequent pediatric abusive head trauma hospitalization rates. JAMA Pediatrics. 2017;171:223.
  3. NINDS shaken baby syndrome information page. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/All-Disorders/Shaken-Baby-Syndrome-Information-Page. Accessed Sept. 8, 2017.
  4. Shaken baby syndrome. American Association of Neurological Surgeons. http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Shaken%20Baby%20Syndrome.aspx. Accessed Sept. 8, 2017.
  5. Narang SK, et al. Acceptance of shaken baby syndrome and abusive head trauma as medical diagnoses. Journal of Pediatrics. 2016;177:273.
  6. Christian C, et al. Child abuse: Epidemiology, mechanisms, and types of abusive head trauma in infants and children. https://www.uptodate.com/contents/search. Accessed Sept. 8, 2017.
  7. Nickels KC (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 21, 2017.
  8. Christian CW, et al. The evaluation of suspected child physical abuse. Pediatrics. 2015;135:e1337.
  9. Paul AR, et al. Non-accidental trauma in pediatric patients: A review of epidemiology, pathophysiology, diagnosis and treatment. Translational Pediatrics. 2014;3:195.