Mobile of teddy bears

Shaken Baby Syndrome

Shaken baby syndrome, is a non-accidental traumatic brain injury (TBI), generally diagnosed in children 3 years old and younger. As the name implies, it often occurs as the result of a baby being shaken by an adult caregiver out of frustration or anger. Babies' brains are delicate, and shaking can result in a severe head injury. Shaken baby syndrome is suspected when a child’s head injuries are inconsistent with the explanation of the injury as given by an adult. An abusive head injury can be caused by one parent, both parents, or caregiver. In less than 14% of cases, the adult is unknown to the family.

Signs and symptoms of Shaken Baby Syndrome are wide-ranging. Essentially, the physical exam, lab tests, and medical imaging conflict with the medical history given by the adult or adults bringing the child in to the hospital. Examples include repetitive injuries that produce outward symptoms over time to sudden trauma. In addition to brain injuries, clinicians also look to other parts of the body for signs of past abuse (broken bones, bruises that are inconsistent with the capability of a baby.)

Tests do not exist to prove intentional or unintentional injuries. However, certain injuries make an unintentional traumatic brain injury unlikely. In babies, retinal and optic nerve sheath injuries, as well as multiple skull fractures from a single fall, are unlikely. In order to differentiate abusive TBIs, clinicians also must rule out other non-intentional causes such as accidental trauma, continuous seizure activity, heart disease, metabolic disease, sepsis, and poisoning.

Babies' brains are delicate, and shaking can result in a severe head injury. Shaken baby syndrome is suspected when a child’s head injuries are inconsistent with the explanation of the injury as given by an adult.

Conventional Treatment

Treatment and prognosis of Shaken Baby Syndrome align with the treatment of TBI - from concussion to life-threatening hemorrhaging and edema. However, treatment is complicated by the difficulty of assessing medical history without a reliable source. The treatment for Shaken Baby Syndrome may also be delayed because adults do not recognize the source of the injury until secondary complications with symptoms such as unresponsiveness and seizures are apparent. This is especially the case if the adult is the abuser and does not want to admit to the abuse or the adult is ignorant of the injury and has not witnessed the injury. Acute treatment includes ensuring that adequate oxygen reaches the brain and that internal brain pressure is normalized. Care includes treating or preventing secondary complications, such as hydrocephalus and infections. Rest, sleep, and stabilization are keys to brain recovery.

 Rehabilitative treatment from Shaken Baby Syndrome includes an array of therapies to treat physical, cognitive, and behavioral impairments. A child may also require assistive devices and may need to relearn to eat, walk, speak and other common skills of daily life. Because a child’s brain is still developing, the after effects of Shaken Baby Syndrome may not be seen until later in life, and may then be seen through a developmental delay, an inability to concentrate, or behavioral problems. Early and intensive rehabilitated treatment is key to helping the brain restore as much function as possible. Preventing further abuse is essential to recovery. Reporting all cases of suspected Shaken Baby Syndrome to authorities is required by law.

Support

At The Brain Possible, our goal is to empower you to take a holistic approach to your child’s treatment. Below are ways in which you can support several aspects of your child’s recovery; before embarking on any, be sure to discuss them with your trusted health care providers.

Physical

Emotional/Social

Sensory

Intellectual

Nutritional/Environmental

Physiological

We understand that the categorization of conditions on The Brain Possible may not perfectly describe your child.

Our goal is inclusivity, opening the door to dialogue and information sharing.