What is Shaken Baby Syndrome?
It only takes a few seconds to change lives forever.
Shaken Baby Syndrome (SBS) is the collection of signs and symptoms resulting from the violent shaking of an infant or small child. It is a form of child abuse. In America last year, approximately 1,200 – 1,400 children were shaken for whom treatment was sought. Of these tiny victims, 25% – 30% died as a result of their injuries. The rest will have lifelong complications. It is likely that many more babies suffered from the effects of SBS and no one knows, because SBS victims rarely have any external evidence of trauma.
SBS is a serious neurological injury – damage to a child’s brain – which is usually accompanied by bleeding behind the eyes and sometimes by other injuries. The damage to the brain is the result of a child’s head being whiplashed back and forth by a violent shaking, and sometimes by the head also being forcefully struck against something. Because a baby’s head is large and heavy relative to its body, and its neck still weak, whiplashing creates powerful forces inside the head. Violent shaking squashes the brain against the skull causing bleeding from torn blood vessels, damage of tissues, and life-threatening swelling of the brain.
The degree of injury to the brain depends primarily on the forcefulness of the shaking and the child’s size. If the initial injuries to the brain are severe, the child will very quickly develop alarming symptoms such as a seizure, stopping breathing and losing consciousness. Even with prompt medical care, about one in five victims will die. Most who survive severe brain injury will have permanent disabilities such as paralysis, blindness, profound developmental delay, and seizures. Some will live in a vegetative state. If the initial injuries to the brain are less severe, children are still likely to have permanent consequences such as movement and coordination problems, intellectual impairment, learning problems, and seizures. Experience to date suggests that all children who survive a severe shaking injury to their brain will requires special care for their lifetime. Even those less severely injured will need special services as they grow into adulthood.
SBS is Child Abuse
Shaken Baby Syndrome is child abuse – it is the consequence of an assault. It is not the result of prudent play, clumsy handling or a competent attempt to revive a baby who has stopped breathing. To inflict SBS, the shaking must be so forceful that any normal adult who happens to witness it would immediately recognize that the child will be hurt.
Fortunately, not all babies who are shaken are injured. No statistics are available yet on the number who are shaken compared to the number who sustain SBS injuries. Most professionals believe that many more children are shaken than are actually injured seriously enough to show symptoms for which parents and caregivers seek medical attention.
Because the likelihood of brain injury decreases with a child’s size, it is not surprising that more infants than toddlers are victims of SBS. Over 50% of all victims are under six months of age. SBS injuries have been inflicted on infants who are just days old and on children three and even four years old. For reasons which are not well understood, boys are at greater risk for being shaken and injured than are girls – close to 60% of victims are boys.
About three quarters of SBS victims are injured by males. Fathers account for between one third and one half, and mother’s boyfriends for about 20%. Caregivers and babysitters injure between 10% and 20% of victims. Most perpetrators are under 25 years of age.
Why do people shake babies?
There is no single answer to this crucial question, but we know two key things about violence and stress. (1) Violent reactions are usually triggered by stress. (2) Adults who injure people tend to have more violent reactions and poorer impulse controls. We know quite a bit about the stresses which trigger baby shaking. The most common “foreground” stress is a baby’s persistent crying; the “background” stresses are usually an adult’s exhaustion and frustration. Toileting and feeding problems are also common triggers. Less is known about the personalities of adults who shake babies. They seem to fall into two general groups: apparently normal people who are “pushed over the edge” by exhaustion and the frustration of coping with an inconsolable baby, and those who already have violent reactions to situations and people.