Shaken Baby Syndrome - Description of the Problem
Shaken Baby Syndrome (SBS) occurs when an adult or older child violently shakes a young child, sometimes hitting the baby's head on a surface such as a bed or floor. When a baby or young child is shaken, the brain moves back and forth within the skull. This motion causes blood vessels within the skull to tear and blood to pool inside the skull, producing irreparable damage to the baby's brain. Shaking can cause many health problems, such as brain injury, cerebral palsy, blindness, hearing loss, learning and behavior problems, seizures, paralysis, and death. There are often no external signs that the baby has been shaken, but there may be bruising or broken bones where the baby was held while being shaken.
Shaking a baby is a very dangerous form of child abuse. One in four children who is shaken dies from their injuries. Of babies who survive, approximately 80 percent suffer from some sort of permanent damage. It is estimated that 1,000-3,000 children in the United States are shaken each year, but it is likely that many cases go unreported or undiagnosed. Financial costs related to shaken baby syndrome can include hospitalization, follow up visits to the hospital and doctor's office, physical and educational therapy, and custodial care (helping the victim with activities such as eating, getting in and out of bed, and bathing). In the United States, care for SBS victims and their families can total 1.2 billion to 16 billion dollars each year. Additional costs include the loss of productivity and wages from working for some victims, as well as legal costs of prosecuting and jailing perpetrators.
Most adults who admit to shaking a baby say that they became frustrated and upset when the baby would not stop crying. Personal issues such as financial stress or problems at work or in relationships can cause an adult to take his or her frustration out on a baby. Most known shaken baby perpetrators are male- either the baby's father or the mother's boyfriend/husband. In some cases, a babysitter or the baby's mother is responsible for the shaking.
It can be difficult to diagnose SBS because some of the symptoms can be attributed to other diseases or disorders, and the person who brings the baby for medical treatment may not be honest about how the baby was hurt or may not know what happened. Many babies later found to have SBS were first brought to the hospital because of falls, difficulty breathing, seizures, vomiting, altered consciousness, or choking. There is an "injury constellation" that doctors use to diagnose SBS, which includes damage to the brain, bleeding under the membranes that cover the brain, and bleeding in the layers of the retina. There are many other findings that reinforce SBS diagnosis, such as evidence of craniofacial impact, rib and long bone fractures, unexplained spinal injury, inflicted skin injuries, and unexplained abdominal trauma.
Evidence based research suggests that programs that teach parents and caregivers about the dangers of shaking a baby, as well as ways to cope with the stresses of caring for a child, are very effective in reducing the incidence of SBS. In New York State, all hospitals are required to offer new parents the option of viewing a video on Shaken Baby Syndrome, including ways to cope with a crying child. It is important to reach as many current or future caregivers as possible to share this important message with them: NEVER EVER SHAKE A BABY.