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Shaken Baby Syndrome (SBS)

What is shaken baby syndrome?

Shaken baby syndrome (SBS) occurs when a newborn or infant, held by the torso, shoulders, or arms, is shaken violently. Anyone who witnesses such an act knows that this is harmful to the baby. A baby’s body is fragile.

When shaken, their head rotates about the neck in any which direction, causing the brain to bleed and swell.

Brain tissue become damaged and never heal. One in every five babies dies of shaken baby syndrome.

Most of the time, the perpetrator of SBS is a family member or caregiver. It happens to infants of all socioeconomic and cultural backgrounds.

Signs and symptoms

After being shaken, the baby may experience:

  • Irritability
  • Sleepiness or lethargy
  • Vomiting
  • Difficulty breathing
  • Tremours
  • Seizures

If the baby has one or more of these symptoms, dial 911 immediately.

Symptoms of SBS may not be noticeable...

Most of the time, these injuries occur inside the brain and head, and their signs may not be noticeable to the naked eye. This is why there are no accurate statistics about the incidence of shaken baby syndrome.

In fact, many of its signs and symptoms are not exclusive to SBS. They can go undetected or be confused with those of other health problems, such as minor falls, regurgitations, crying spells, or irritability. Usually, Babies with SBS do not experience fever or diarrhea.

As in other regions, it is difficult to determine the exact number of cases of shaken baby syndrome in Quebec. However, the CHUSJ has observed a rising number of SBS cases in Quebec with a reported incidence of about 30 cases each year. This number is low because it reflects only the most severe cases of SBS needing emergency medical attention and hospitalization.

According to a study, the number of shaken children under two years of age is believed to be much higher, in about 5% of families.

Serious consequences

  1. For the baby

Violently shaking a baby results in serious brain injury:

  • Intracranial hemorrhaging (bleeding in the brain)
  • Retinal hemorrhaging (bleeding in the eye)
  • Cerebral œdema (swelling of the brain), and damaged cerebral nerve tissue

These injuries can be accompanied by other signs of trauma:

  • Fractured ribs, arms, or legs
  • Fractured skull
  • Bruises on the head or body
Remember !

Most of the time, the signs of SBS are not visible.

Two thirds of young victims of shaken baby syndrome suffer permanent damage:

  • Paralysis (hemiparesis, hemiplegia, quadriplegia)
  • Blindness
  • Epilepsy
  • Eating disorders
  • Sleep disorders
  • Developmental delays (motor, speech-language)
  • Cognitive impairments

Recent studies showed that SBS victims who do not appear to suffer any permanent damage may, nevertheless, have learning difficulties and socialization problems in later childhood.

In fact, 40% of young victims who suffer devastating consequences of SBS require treatment and care from various medical specialists (neurologist, neurosurgeon, ophthalmologist) and rehabilitation specialists (occupational therapist, physiotherapist, social worker), and sometimes for the rest of their lives.

  1. For families

The family will naturally react with great shock. Such a violent act is unexpected and takes everyone who looks after the baby by surprise. Sometimes, people (spouses) living together under the same roof cannot bring themselves to accept reality, even with all the facts in front of them and the child’s apparent symptoms.

In such situations, couples, spouses, parents, and even the child care worker or caregiver (babysitter) often feel they are to blame for having left the child in the perpetrator’s care. In essence, they are the second victims. As a result, the family will have to undergo an investigation to ensure the protection of the young victim and that of any other child in the family. Family members, namely the father and mother, will be questioned by a number of different departments.

Babies are fragile

Babies and young infants are fragile. The structure of their developing brain is delicate and can easily suffer damage. Newborns are particularly sensitive to any shaking because, contrary to adults, the weight of a newborn’s head is heavier in proportion to that of their body, and the muscles in their neck are not developed enough to resist the kind of head movements that occur when shaken.

Moreover, at this stage of development, the brain somewhat floats inside the skull, and its matter is friable and less dense, making it more sensitive to distortion when the head suffers any abrupt movements. It is important to know that damaged brain tissue does not regenerate. 

What brings someone to shake a baby?

The baby’s persistent and excessive crying is the main trigger of shaken baby syndrome. The person looking after the baby is not able to comfort the child and will gradually become frustrated.

While dealing with the baby’s incessant crying, the person will go through different stages of emotions, questioning themselves, feeling powerless, irritated, followed by anger triggering a loss of control that degenerates into violence. This anger is often the expression of a deep sense of helplessness when faced with new parental responsibilities and all of the life changes that come with them.

Everyone is at risk

A violent act of this nature can even happen in families that do not appear to be at risk. There are certain situations that will make a person more vulnerable:

  • Fatigue
  • Lack of sleep
  • Conjugal or family problems
  • Life changes after the baby’s arrival are not what was expected
  • Use of medication
  • Alcohol or drug abuse
  • Money issues or concerns
  • Baby’s health problems make the parent feel burdened
  • Persistent and excessive crying
  • Parent’s tolerance level has reached its limit
About this page
Updated on 10/6/2014
Created on 10/6/2014
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