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Alternative names Return to top
Shaken impact syndrome; Whiplash - shaken infantDefinition Return to top
This is a severe form of head injury caused by violently shaking an infant or child, usually when the infant is crying inconsolably and the frustrated caregiver loses control. The violent shaking may result in severe injuries to the infant, permanent brain damage, or death. Shaken baby injuries usually occur in children younger than 2 years old but may be seen in children up to the age of 5.Considerations Return to top
Shaken baby syndrome can occur from as little as 5 seconds of shaking. Injuries are most likely to happen when there is both acceleration (from shaking) and deceleration (from the head hitting something). Even hitting a soft object, such as a mattress or pillow, may be enough to injure newborns and small infants. The result is a type of whiplash, similar to that seen in some auto accidents.
A number of factors make infants highly vulnerable to whiplash forces. For example, their brains are softer, their neck muscles and ligaments are weak and not fully developed, and their heads are large and heavy in proportion to their bodies.
When an infant or toddler is shaken, the brain rebounds against the skull. This can cause bruising of the brain (cerebral contusion), swelling, pressure, and bleeding in the brain (intracerebral hemorrhage).
The large veins along the outside of the brain may tear, leading to further bleeding, swelling, and increased pressure (subdural hematoma). This can easily cause permanent brain damage or death.
Shaking an infant or small child may cause other injuries, such as damage to the neck, spine, and eyes. Eye damage is very common and may result in loss of vision (retinal hemorrhage).
Causes Return to top
In most cases, an angry parent or caregiver shakes the baby to punish or quiet the child. Many times the caregiver did not intend to harm the baby. Nevertheless, it is a form of child abuse.
Shaken baby syndrome does not result from gentle bouncing, playful swinging or tossing the child in the air, or jogging with the child. It also is very unlikely to occur from accidents like falling off chairs or down stairs, or accidentally being dropped from a caregiver's arms. Short falls may cause other types of head injuries, although these are often minor.
Symptoms Return to top
The symptoms can vary from mild to severe. They may include:There are usually no outward physical signs of trauma, such as bruising, bleeding, or swelling. An ophthalmologist examining the infant's eyes may detect retinal hemorrhage (bleeding behind the eye) or retinal detachment.
In some cases, the condition can be difficult to diagnose and may not be identified during an office visit.
First Aid Return to top
Do Not Return to top
Call immediately for emergency medical assistance if Return to top
Prevention Return to top
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Page last updated: 28 October 2004 |