by EBSCO Medical Review Board
(Shaken Impact Syndrome)

Definition

Shaken baby syndrome is a brain injury from physical abuse to a baby or young child. It may cause lasting brain damage or death. Treatment is needed right away.

Causes

Shaken baby syndrome is caused by shaking or jerking a baby or young child. Even a few seconds of abuse can cause injury because their neck muscles are not strong and their brains are still developing.

This condition often happens when a parent or other caregiver becomes angry or frustrated, such as when a baby will not stop crying.

Brain Bruised from Whiplash—Similar Effect in Shaken Baby Syndrome
Whiplash brain
Copyright © Nucleus Medical Media, Inc.

Risk Factors

Things that may raise the risk of this injury include a family history of:

  • Domestic or child abuse
  • Drug or alcohol abuse
  • Stress or social problems

Symptoms

Symptoms can vary based on the injury. They may be:

  • Fussiness
  • Not growing as expected
  • Poor feeding or vomiting
  • Moving less often or stiff muscles
  • Pupils that are not the same size
  • Problems tracking objects
  • Seizures or spasms
  • Not fully awake or aware of surroundings
  • Problems breathing
  • Skin that has a blue color
  • Head swelling

Some children do not signs of abuse that can be seen. Children who do may have cuts, swelling, or bruises to the face, head, arms, belly or back.

Diagnosis

You will be asked about your child’s symptoms and health history. A physical exam will be done. The child may need to see a doctor or surgeon who treats brain problems.

An eye exam may be done to look for bleeding inside the eyes.

Imaging tests will be done to look for injuries. This can be done with:

Treatment

Treatment is needed right away to lower the risk of brain damage. This can be done with supportive care to help with basic functions like breathing.

Easing Pressure on the Brain

Treatment may be needed to ease pressure on the brain caused by bleeding or swelling. This can be done with:

  • Medicine
  • Draining fluid from the head
  • Surgery to remove blood on the brain or rarely to remove part of the skull

Prevention

Shaken baby syndrome can be prevented by not shaking a baby or young child. Frustrated parents and caregivers should place the baby in a safe place and call a friend or family member to help.

RESOURCES

Brain Injury Association of America  http://www.biausa.org 

Healthy Children—American Academy of Pediatrics  http://www.healthychildren.org 

CANADIAN RESOURCES

Caring for Kids—Canadian Paediatric Society  http://www.caringforkids.cps.ca 

Sick Kids—The Hospital for Sick Children  http://www.sickkids.ca 

References

Abusive head trauma. Kids Health—Nemours Foundation website. Available at: http://kidshealth.org/parent/medical/brain/shaken.html. Updated November 2019. Accessed January 6, 2020.

Concussion and mild traumatic brain injury. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/concussion-and-mild-traumatic-brain-injury . Updated November 1, 2018. Accessed January 6, 2020.

Management of Concussion/mild Traumatic Brain Injury Working Group. United States Department of Veterans Affairs/Department of Defense (VA/DoD) clinical practice guideline for management of concussion/mild traumatic brain injury. VA/DoD 2016.

Moderate to severe traumatic brain injury. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/moderate-to-severe-traumatic-brain-injury . Updated November 19, 2019. Accessed January 6, 2020.

Shaken baby syndrome. American Association of Neurological Surgeons website. Available at: http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Shaken%20Baby%20Syndrome.aspx. Accessed January 6, 2020.

Revision Information

  • Reviewer: EBSCO Medical Review Board Kari Kassir, MD
  • Review Date: 09/2019
  • Update Date: 07/20/2020