SHAKEN BABY SYNDROME

What is Shaken Baby Syndrome? Shaken baby syndrome is cause by vigorous shaking of an infant or young child by the arms, legs, chest or shoulders. Forceful shaking can result in brain damage leading to mental retardation, speech and learning disabilities, paralysis, seizures, hearing loss and even death. It may cause bleeding around the brain and eyes, resulting in blindness. A baby’s head and neck are especially vulnerable to injury because the head is so large and the neck muscles are still weak. In addition, the baby’s brain and blood vessels are very fragile and easily damaged by whiplash motions, such as shaking, jerking and jolting.


SHAKEN BABY SYNDROME INTRODUCTION:
Shaken baby syndrome destroys a child's brain cells and prevents his or her brain from getting enough oxygen.
Shaken baby syndrome is a form of child abuse that can result in permanent brain damage or death. Shaken baby syndrome also known as abusive head trauma, shaken impact syndrome, inflicted head injury or whiplash shake syndrome is a serious brain injury resulting from forcefully shaking an infant or toddler.

DEFINITION:
Shaken Baby Syndrome (SBS), a form of abusive head trauma (AHT) and inflicted traumatic brain injury (ITBI), is a preventable and severe form of physical child abuse.
It results from violently shaking an infant by the shoulders, arms, or legs. SBS may result from baby shaking alone or from impact (with or without shaking).The resulting whiplash effect can cause bleeding within the brain or the eyes.
Nearly all victims of SBS suffer serious health consequences and at least one of every four babies who are violently shaken dies from this form of child maltreatment.

INCIDENCE :
Estimated death rates among infants with SBS range from 15% to 38%. Non-fatal consequences of SBS include varying degrees of visual impairment including blindness, motor impairment (e.g. cerebral palsy and impairments).
An estimated two to three babies out of 10,000 are victims of Abusive head trauma in the United States each year. About one in five of these babies dies, and only about a third will survive without severe disabilities. Boys are shaken more often than girls, and it's usually a parent or parent's partner who does the shaking. Most often a father, stepfather, or boyfriend abuses the child.

SHAKEN BABY SYNDROME FACTS:
Shaken baby syndrome is a form of child abuse.

CAUSES OF SHAKEN BABY SYNDROME:
Infants have very weak neck muscles and large and heavy heads in proportion to their bodies. In addition, because the infant brain is immature and needs room to grow, there is naturally a virtual space between the skull and brain to allow for development. Violently shaking an infant can cause the brain to move within the skull, resulting in cerebral contusions (bruising of brain tissue) and shearing (tearing) of blood vessels. Most commonly, the injuries associated with shaken baby syndrome include bleeding around the brain (subdural and subarachnoid hemorrhages), bleeding in the eyes (retinal hemorrhages), and spinal cord or neck injuries. Often infants will also have evidence of other non-accidental injuries, including unexplained bruises, rib fractures, or extremity fractures.

SIGNS AND SYMPTOMS :
It depends on how long and hard the child has been shaken or the extent of the child's other head injuries.

SIGNS OF ABUSIVE TRAUMA
The signs of abusive head trauma depend on the extent of the damage. The most common signs include not eating or difficulty feeding, rigidity, glassy eyes, unable to lift head, unable to focus on an object, vomiting, lethargy, irritability. As brain cells are destroyed and oxygen is depleted in the brain, neurological changes continue to occur. In severe cases, a child may have difficulty breathing or suffer from seizures or heart failure. He may lose consciousness and become comatose.
Abusive head trauma results from injuries caused by someone (most often a parent or other caregiver) vigorously shaking a child or striking the child's head against a surface. In many cases, the caregiver cannot get the baby to stop crying and, out of frustration or anger, will shake the baby. Unfortunately, the shaking may have the   0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 24 desired effect: Although at first the baby cries more, he or she may stop crying as the brain is damaged.

PREVENTING ABUSIVE HEAD TRAUM A:
Abusive head trauma is 100% preventable. A key aspect of prevention is increasing awareness of the potential dangers of shaking. Picking up a baby and shaking, throwing, hitting, or hurting him/her is never an appropriate response.
All Babies Cry is a national program that promotes healthy parenting behavior through practical demonstrations of infant soothing and ways to manage the stress of parenting. The program is divided into four parts:  0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1  4. Swaddling (wrapping the baby in a blanket like a "burrrito" to help him or her feel more secure. Hips and knees should be slightly bent and turned out). 5. Swinging gently (rocking in a chair, using an infant swing, or taking a car ride to help duplicate the constant motion the baby felt in the womb).

ROLE OF PARENTS:
Make sure the baby's basic needs are met Check for signs of illness, like fever or swollen gums. Rock or walk with the baby.
Sing or talk to the baby. Offer the baby a pacifier or a noisy toy. Take the baby for a ride in a stroller or strapped into a child safety seat in the car. Hold the baby close against your body and breathe calmly and slowly. Give the baby a warm bath. Pat or rub the baby's back. Learn how to respond to their own stress.

PROGNOSIS
Prognosis depends on severity and can range from total recovery to severe disability to death when the injury is severe. One third of these patients die, one third survives with a major neurological condition, and only one third survives in good condition. The most frequent neurological impairments are learning disabilities, seizure disorders, speech disabilities, hydrocephalus, cerebral palsy, and visual disorders