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syndrome is brain injury that occurs when someone shakes a baby or throws a baby
against an object. It is a form of child abuse. It may happen to children up to 5 years of age, but it is most common in babies younger than 1 year old.
It is never okay to shake or throw a young child. It may not leave any obvious sign of injury, but it can cause serious long-term
problems or even death.
syndrome often occurs when a baby won't stop
crying and a caregiver loses control of his or her emotions. Parents can help prevent this problem by learning healthy ways to relieve stress and anger. It's also important to choose child care providers carefully.
syndrome may also be called "shaken-impact syndrome." Many doctors use the term "abusive head trauma" to describe the injury. They may use "intentional head
injury" to describe how it happened.
When a baby is shaken or thrown, the head twists or whips back and forth. This can cause tears in brain tissue, blood vessels, and nerves. The child's brain slams against the skull. This can cause bleeding and swelling in the brain.
Young children are at high risk for brain
injury when they are shaken or thrown. That's because they have:
Normal play, such as bouncing a child
on a knee or gently tossing a child in the air, does not cause shaken baby
Symptoms vary among children
based on how old they are, how often they've been abused, how long they were abused
each time, and how much force was used.
Mild injuries may cause
subtle symptoms. For example, a child may:
A child with more severe injuries may have symptoms such as:
A child who has been shaken or thrown may also have other signs of
abuse, such as broken bones, bruises, or burns.
Symptoms can start quickly, especially in a badly injured
child. Other times, it may take a few days for brain swelling to cause symptoms.
Sometimes caregivers who harm a child will put the child to bed. They may hope that
symptoms will get better with rest. By the time the child gets to a doctor, the
child may need urgent care. In some cases, the child may be in a coma before a
caregiver seeks help.
Shaken baby syndrome
can be hard to detect because often there aren't clear signs of abuse. Instead, a baby
may have vague symptoms, such as vomiting or a poor appetite. At first these symptoms may seem related to an infection, such as the flu or
a kidney infection. Sadly, shaken
baby syndrome may not be discovered until repeated abuse or more severe
To confirm a diagnosis of shaken baby syndrome, a doctor will:
A doctor may also do tests to rule out other possible causes of the child's symptoms.
For example, a
lumbar puncture checks the spinal fluid for signs
of meningitis. Blood tests may be done to check for internal injuries or to rule out other conditions, such as rare blood disorders.
A doctor who suspects shaken baby
syndrome must report it to the local child welfare office and police.
A child with shaken baby
syndrome needs to be in the hospital, sometimes in an intensive care unit
Oxygen therapy may be used to help the child breathe.
Doctors may give the child medicine to help ease brain swelling. Sometimes a
cooling mattress will help lower the child's body temperature and reduce brain
Depending on the symptoms, doctors may try seizure
medicine, physical therapy, or other treatments. A child who has severe bleeding in the brain may need
A child may
have brain damage that causes one or more serious problems, such as:
Some children die from their injuries.
It is important to get help if
something doesn't seem right with your baby. Shaken baby syndrome may cause
only mild symptoms at first, but any head injury in a young child can be
Call 911 or other emergency services immediately if a child:
Young children can't defend themselves, so it is up to adults who care to protect them. If you suspect abuse and the child is not in immediate danger:
Health Tools help you make wise health decisions or take action to improve your health.
Learning about shaken baby syndrome:
The National Center on Shaken Baby Syndrome is a
worldwide nonprofit organization that provides information to professionals and
parents about recognizing and preventing this form of child abuse.
The National Institute of Neurological Disorders and
Stroke (NINDS), a part of the National Institutes of Health, is the leading
U.S. federal government agency supporting research on brain and nervous system
disorders. It provides the public with educational materials and information
about these disorders.
The American Academy of Pediatrics (AAP) offers a
variety of educational materials about parenting,
general growth and development, immunizations, safety, disease prevention, and more. AAP guidelines for various conditions and links to other
organizations are also available.
The Child Welfare Information Gateway is a national
resource for people seeking information about how to prevent, identify, and
treat child abuse and neglect. The website has information about family
support services, fostering and adopting a child, and child welfare issues.
There are also links for many toll-free crisis hotline numbers.
The Shaken Baby Alliance supports families and
professionals in the fight against Shaken Baby Syndrome/Abusive Head Trauma and
other forms of child abuse. The Alliance offers printed materials and support
services by phone.
Other Works Consulted
Saunders BE, et al., eds. (2004). Child Physical and Sexual Abuse: Guidelines for Treatment (Revised). Charleston, SC: National Crime Victims Research and Treatment
Center. Also available online:
American Academy of Pediatrics (2007, reaffirmed 2012). Evaluation of suspected child physical abuse. Pediatrics, 119(6): 1232–1241. Also available online: http://pediatrics.aappublications.org/content/119/6/1232.full.
American Academy of Pediatrics (2008). Promoting mental health. In Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 3rd ed., pp. 77–107. Elk Grove Village, IL: American Academy of Pediatrics.
Braverman RS (2012). Eye. In WW Hay Jr et al., eds., Current Diagnosis and Treatment: Pediatrics, 21st ed., pp. 424–464. New York: McGraw-Hill.
The Arc (accessed October 2012). Shaken Baby Syndrome. Silver Spring, MD: The Arc. Available online: http://www.thearc.org/page.aspx?pid=2549.
August 13, 2013
John Pope, MD - Pediatrics & Chuck Norlin, MD - Pediatrics
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