Shaken baby syndrome (SBS) is a complex of organic disorders that can occur if the child’s body experiences a concussion. The baby’s head dangles, causing the membranes of brain cells to rupture. As a result, there is damage to the brain and hemorrhages under the membranes of the brain (without external signs of damage). Shaken baby syndrome is one of the main causes of infant death. At the same time, this syndrome does not necessarily arise because of maltreatment of the child.
Causes of Shaken Baby Syndrome
In babies under one year old, the head is the largest and heaviest part of the body (up to 15% of the total body mass). Against the background of a large head, neck muscles are extremely weak.
Such features of the anatomical structure make the baby susceptible to injuries due to acceleration-deceleration movements.
In this case, this syndrome occurs not only in the rough treatment of a baby or an unexpected traffic accident, accompanied by a sudden hit.
It can happen during a game with babies, for example, when adults throw a child high in the air or shake too sharply, in case of traffic accidents as a result of hitting the car from behind, etc.
How to Diagnose the SBS?
Children of the first year of life have the greatest risk of injury due to strong shaking.
Often the syndrome of children’s concussion is masked by other disorders, since there are no traces of external trauma, and the clinical picture is very diverse. At the same time, the history data rarely correspond to the severity of the condition of a small patient.
The entire complexity of diagnosis is associated with the development of intracranial hemorrhages invisible to the parent. Most often when using different methods of neurovisualization (eg, neurosonography, computed tomography, etc.) subdural or subarachnoid hemorrhages (volume accumulation of blood between the brain tunics), brain edema, retinal hemorrhage are detected.
The difficulties of diagnosing, and, consequently, promptly initiated treatment contribute to the development of such terrible complications as respiratory or cardiopulmonary insufficiency.
What are the main clinical manifestations of Shaken baby syndrome? A child may become drowsy, lethargic or, conversely, extremely irritable. There may be convulsions, a decrease in muscle tone in combination with a fever, a bulging and pulsation of a large fontanel, a decrease in the appetite of the child, unjustified by other conditions, and a refusal to eat.
A very dangerous sign is the cessation of breathing (apnea) and a violation of cardiopulmonary activity.
But in the latter case, unlike the previous ones, the child is always hospitalized, where he can receive timely specialized medical care.
A very important point, which will help to make the correct diagnosis and help the baby in a timely manner, is an indication of a possible trauma (shaking) in the anamnesis.
The most common symptom is retinal hemorrhage, occurring from 50% to 90% of cases with severe traumatic shaking of the baby.
A number of doctors believe that in isolation this feature cannot be the main diagnostic criterion. But in combination with intracranial lesions it serves as confirmation of the diagnosis. Hemorrhages in the optic nerve sheath, identified posthumously, are also markers of the disease.
Like any intracranial hemorrhage, depending on the severity, localization and extent of the pathological process, the syndrome of childhood concussion may subsequently lead to loss of vision, hearing, speech disorders, the formation of cerebral palsy and mental retardation, and in the case of pronounced breathing disorders and cardiovascular pulmonary activity – to death.
All the consequences of this state are very serious and irreversible.
Shaken Baby Syndrome Consequences
- Mental retardation
In the United States, 2,000 infants die of SBS annually, in England — 100. Globally, there are an average of 27 cases of SBS per 100,000 babies. High rates of Shaken baby syndrome are in Estonia (40.5 per 100 thousand). For many countries there is no accurate data. Based on the research conducted in the USA and England, fathers-stepfathers (68-83%) are most often responsible for SBS, followed by nannies (8-17%) and mothers (9-13%). Keep in mind that even a slight shaking of the infant may lead to such damage to his brain, from which 10-20% of infants die, and 75% suffer from brain injuries with unpredictable consequences throughout their lives.
Recommendations for Reducing Cases of SBS
- Never shake a child who has not reached the age of two.
- When you take a newborn in your arms, support his head.
- It is important to understand that a child is not crying because he wants to infuriate you. He may be hungry, sick, or may have other important reasons.
- Over time, the child will grow up and stop screaming and crying. In the meantime, you need to cope with this situation without losing your temper.
How to Prevent Baby Shaken Syndrome?
Often parents ask: how to calm the baby? How to do it right?
To answer these questions let’s turn to nature. The baby, being in the womb, experiences some rocking movements at each step. But their amplitude is quite small, and the movements are monotonous and smooth.
Therefore, when rocking a child, it is worth imitating the same movements that he experienced in the womb.
Together with the sound of the mother’s heart, being in her arms, such rocking movements really help to calm the baby. However, if such techniques do not work, a long cry of the infant should not provoke parents to sudden rock motion.
It is necessary to turn to a pediatrician, as the pathology of various systems and organs can be hidden behind a long cry.
But it is also not necessary to go to extremes and treat a child like a rare crystal vase.
It is important to stick to the middle ground. Always keep in mind that a gentle, warm and loving touch of parents will help the baby on his way to reaching new heights.