Shaken baby syndrome, which may result in severe brain trauma, is caused when a child is violently shaken and the child’s head is whipped back and forth, resulting in rapid, repeated, severe acceleration and deceleration of the head.

The degree of brain damage depends on how hard and how long the baby is shaken. Signs and symptoms of this form of abuse may range from minor—irritability, lethargy, tremors, vomiting, to major—seizures, coma, stupor, and death. Destruction of brain cells from shaking with or without impact, lack of oxygen to the brain cells, and swelling of the brain cause the neurological damage.

“Shaking occurs frequently when a frustrated caregiver loses control with an inconsolable crying baby,” says Resmiye Oral, M.D., University of Iowa Children's Hospital pediatrician and clinical director of the Child Protection Program. “It is important to realize that just saying ‘don’t shake a baby’ is not enough. Caregivers need to know what to do when a baby will not stop crying.”

First, be sure the baby’s basic needs are met:

• Feed and burp the baby
• Change the diaper
• Make sure clothing isn't too tight
• Make sure the baby isn't too hot, or too cold

Try these ways to soothe the baby:

• Take the baby for a walk outside in a stroller or for a ride in the car seat
• Hold the baby against your chest and gently massage the baby
• Rock, walk, or dance with the baby
• Offer a pacifier
• Lower any surrounding noise and lights
• Sing or talk to the baby using soothing tones
• Play a recorded soothing sound (relaxing instrumental music)

If the baby continues to cry, and it is beginning to bother you:

• Call a friend or relative you trust to take over
• Be patient; take a deep breath and count to 10
• Hold the baby and breathe slowly and calmly; the baby may feel your calmness and become quiet
• Play soothing music
• Put the baby in a safe place (playpen, crib with rails up, etc.) go to another room, get some rest, take care of yourself

Did you know?

One shaken baby in four dies. While there are not consistent statistics, estimates are that 15 percent of child deaths are due to battering, or shaking.

Physical abuse is the most common cause of mortality and accounts for the most long-term disability in infants and young children.

Approximately 20 percent of diagnosed cases are fatal in the fi rst few days after injury. The majority of the survivors are left with handicaps ranging from mild—learning disorders, behavioral changes—to moderate and severe—profound mental and developmental retardation, paralysis, blindness, inability to eat, or existing in a permanent vegetative state. Shaken baby syndrome victims range in age from a few days to 1–2 years; the average is six months.

Almost 80 percent of perpetrators are male. UI Hospitals and Clinics Child Protection Program provides services for suspected victims of child abuse and neglect. To schedule an appointment in the Child Assessment Clinic, please call 319-353-6128 or 319-356-7206 or 319-356-4920.

For More Information:

• Nemours Foundation: Shaken Baby/Shaken Impact Syndrome

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