Shaken Baby Syndrome
Charles Sprague, M.D. Boys Town Pediatrics
Shaken Baby Syndrome is probably one of the most, if not the most difficult things we deal with as pediatricians. You know, you have these very vulnerable young infants who for one reason or another put themselves into harm's way, and injury is then inflicted onto them by one of their caregivers.
The babies are susceptible to injury for several reasons most of it has to do with a very large size of their heads and their poor head control. That large size, poor muscle control so there is going to be a lot of forces a lot of shaking.
Any shaking is going to lead to a tremendous amount of force within the head of the kids. But it really takes a significant shaking and force to create that injury. It is not going to happen with the playful bouncing on the knee, or you know a lot of kids when they get some head control you will see them being tossed up in the air and caught in kind of a playful manner. Those types of things are not going to create shaken baby syndrome.
These are truly inflicted, typically out of anger, pretty violent events.
There can be a variety of symptoms. The main symptom that children will present with shaken baby syndrome is seizures. So a young child, typically somewhere 3 to 5, 3 to 6 months of age will present to a medical facility having had seizures.
The other issue would be apnea, or just the stoppage of breathing, or just an incredibly fussy, irritable, unexplained irritability.
Anywhere from 15 to 25 percent of cases end in death, so this is a cause of death with infants, in this age group. The ones that are fortunate enough to survive end up with long term neurological problems: often blindness sometimes, some hearing deficits, learning disabilities, permanent seizure disorder.
A lot of them really fail to achieve their normal neurological milestones that you would expect your average toddler and kid to achieve.
I do not bring it up directly with many families, but if I do have a baby who is extremely colicy and a extremely fussy baby. I do make sure I have a one-on-one conversation with those parents to make sure these are the kids that put themselves at risk. And none of us think we will be the perpetrator, but we all have a breaking point, we all have those thresholds. So, you have got to know your own limitations.
You have got to not be afraid to go get your own help. Accept and admit, when you are at your end and you need that help before you do something foolish.
Shaken baby syndrome is caused by vigorous shaking of an infant or young child by the arms, legs, chest or shoulders. Dr. Charles Sprague, pediatrician with Boys Town Pediatrics, explains why babies are at risk, the effects of shaken baby syndrome, and offers advice to parents and caregivers on how to prevent shaken baby syndrome.