File - Shaken Baby Syndrome

Shaken Baby Syndrome
Cinthya Vidales, RN, BSN
What is Shaken Baby
Syndrome (SBS)?
 Another name is Abusive Head Trauma (AHT) or
Shaken Impact Syndrome (SIS).
 This happens when a “frustrated caregiver violently
shakes, slams, hits, or punches a child’s head, usually
to stop them from crying or to get them to respond to
the expectations of the caregiver” (The Shaken Baby
Alliance, 2009).
What is Shaken Baby
Syndrome (SBS)?
 The baby’s brain rebounds inside the skull when
shaken. This injury will cause bruising of the brain,
swelling, pressure, and bleeding (intracerebral
hemorrhage). This can easily lead to permanent brain
damage or death (Kaneshiro & Zieve, 2011).
 SBS is a leading cause of child abuse deaths in the
United States.
 At least one in four babies dies as a consequence of
this form of abuse.
 Infants up to 4 months are at greatest risk of injury from
 Inconsolable crying is a primary trigger for shaking a
CDC, 2010
 It is estimated that approximately 1,000 to 3,000
children suffer from SBS
 80 percent of survivors suffer from permanent damage.
 the United States, the costs of hospitalization and
continuing care for SBS victims can total $1.2 to $16
billion dollars each year.
(New York State Dept of Health, 2010)
 It is estimated that perpetrators in 65% to 90% of cases
are males — usually either the baby's father or the
mother's boyfriend, often someone in his early twenties
(KidsHealth, 2012).
 Can occur in as little as 5 seconds of shaking
(Kaneshiro & Zieve, 2011).
Videos on SBS
What happens when shaking
a baby
3D Simulation of brain injury
and hemorrhage
Shaken Baby Syndrome is
a Preventable Public
Health Problem!
CDC, 2010
What are the signs?
Usually there are no outward physical signs of
trauma, but there may be a change in the child's
behavior such as irritability, lethargy, pale or bluish
skin, vomiting, and convulsions (Kaneshiro & Zieve).
 May also exhibit limpness in arms and legs or
 Decreased level of consciousness
 Vomiting; poor feeding
 Inability to suck or swallow
 Changes in feeding and napping patterns
Clinical Manifestations
 Respiratory difficulty including apnea
 Decreased level of consciousness
 Seizure activity
 Bradycardia
 Bulging fontanels indicative of increased intracranial
 Possible complete cardiovascular collapse requiring
(Miehl, 2005)
Diagnostic Exams
 CT scan
 MRI scan
 Eye examination
Clinical Findings
 Subdural hemorrhage (A)
 Retinal detachment/hemorrhage (B)
Retinal Hemorrhage
 Retinal hemorrhage is a cardinal display of Shaken
Baby Syndrome.
 Occurs from the repeated acceleration-deceleration
 Results in vitreo-retinal traction and perhaps damage to
blood vessels and nerves behind the eye (orbit)
 Essential that ophthalmologists familiar with ocular
findings in SBS, evaluate suspected child victims
(Levin, 2006)
Subdural Hemorrhage
 The brain rotates within the skull cavity, injuring, or
destroying brain tissue
 When shaking occurs, blood vessels feeding the brain
can be torn, leading to bleeding around the brain.
 Blood pools within the skull, sometimes creating more
pressure within the skull and possibly causing
additional brain damage.
The National Center on
Shaken Baby Syndrome,
Long-Term Consequences
 Learning & Physical
 Visual disabilities or
 SBS survivors may
have long term visual
compromise. The main
cause is brain injury to
the vision centers
(occipital lobes) and
direct optic nerve injury.
 Hearing impairment
 Cognitive impairment
 Speech disabilities
 Cerebral Palsy
 Seizures
 Behavior disorders
 Death
The National Center on
Shaken Baby Syndrome,
Tips for Parents
 It is important to educate parents and caregivers about the
dangers of SBS. Anyone caring for a child should know that if a
baby is not uncomfortable or sick but will not stop crying, it is okay
to put the baby down in a safe place (like a crib) and take a short
break to relax.
 • New parents should know that it is common for babies to cry for
up to three hours a day – some cry even more than this.
 •Some states such as New York have legislation requiring that
hospital maternity wards offer to show new parents a video on
shaken baby syndrome before they leave the hospital.
 • If you suspect a baby has been shaken, you should call 911 or
take the baby to the closest hospital emergency room.
(New York State Dept of Health, 2010)
Tips for Parents
 NEVER shake a baby or child in play or in anger. Even gentle shaking can
become violent shaking when you are angry.
 Do not hold your baby during an argument.
 If you find yourself becoming annoyed or angry with your baby, put him in the
crib and leave the room. Try to calm down. Call someone for support.
 Call a friend or relative to come and stay with the child if you feel out of
 Contact a local crisis hotline or child abuse hotline for help and guidance.
 Seek the help of a counselor and attend parenting classes.
 Do not ignore the signs if you suspect child abuse in your home or in the
home of someone you know.
Kaneshiro & Zieve, 2011
Further Study
 Click on the following link to read more on SBS
 Please follow the link on the website to take the quiz on
Shaken Baby Syndrome.
 At the end of the quiz you will be able to see the correct
Centers for Disease Control and Prevention, National Center for Injury Prevention and Control.
(2010). Heads Up: Preventing Shaken Baby Syndrome- Guide for
Departments and Community Based Organization. Retrieved January
31, 2012 from
Kaneshiro, N. K & Zieve, D. (2011). Shaken Baby Symptoms. Retrieved January 30, 2012
KidsHealth (2012). Abusive Head Trauma (Shaken Baby Syndrome). Retrieved February 6, 2012 from
Levin, A. (2006). Eye Findings in Shaken Baby Syndrome. Retrieved January 31, 2012
Miehl, N. (2005). Shaken Baby Syndrome: Clinical Presentation of SBS. Medscape. Retrieved
January 31, 2012 from
New York State Department of Health (2010, October). Shaken Baby Syndrome: Facts and
Retrieved February 3, 2012 from
The National Center on Shaken Baby Syndrome (n.d). “Long-Term Consequences”. Retrieved
January 31, 2012 from
The Shaken Baby Alliance. (2009). What is Shaken Baby Syndrome/Abusive Head Trauma? Retrieved
January 30, 2012 from
Missouri Department of Health and Senior Services. (2011 Oct 10). Never Shake: Preventing Shaken
Syndrome. [Video file]. Retreived February 9, 2012 from
New Mexico Aging and Long-Term Services Department. (2010 Nov 10). TBI in Young Children 4:
Baby Syndrome and Normal Infant Crying. [Video file]. Retrieved February 3, 2012
Oopshansoo. (2010 Mar 17). Shaken Baby Syndrome 3D. [Video file]. Retrieved February 3, 2012
Tavares, S. (2008). The Rupture of Bridging Veins in Shaken Baby Syndrome. [Video file]. Retrieved
February 3, 2012 from

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