2. What is Shaken Baby Syndrome
(SBS)?
Also known as:
Abusive head trauma (AHT)
Shaken impact syndrome
Inflicted head injury
Whiplash shake syndrome
SBS used to describe the injuries that can result if an infant or
small child is violently shaken.
Child abuse
Most common cause of non-accidental head injury
3. Victims
Majority are < 1 yrs of age
Can occur up to 5 y/o
Highest rate is 6-8 wks old
In U.S., annual incidence: 20-
30/100,000 babies
Higher risk: Males
More prevalent: Whites,
Blacks
1/3 no long-term effects
1/3 significant injuries
1/3 die
4. Risk Factors
Special needs
Developmental delays
Prematurity/LBW
Multiple siblings
Colic/GERD
Inconsolable, frequent crying
Young or single parents
Unstable family situations
Stress
Domestic violence
Alcohol or substance abuse
Hx of parent being
mistreated as a child
Low education level
Low socioeconomic status
5.
6. Perpetrators
70% Male
Father/Stepfather
Mother’s boyfriend
Babysitters
Daycare workers
Mothers
Anyone:
Easily frustrated/poor impulse control
Unable to handle stressful situations
With aggressive behavior
11. My Stance
SBS/AHT significant problem in U.S.
Child abuse issue
Economic issue
Need more awareness & prevention
Educate parents and caregivers
Must be reported!
Never shake a baby!
12. Class
Discussion
Why do you think there is
a lack of awareness of
SBS?
What do you think we can
do to raise awareness &
prevention of SBS?
Can you think of any
cases where SBS is not
intentional?
13. References
Goulet, C., Frappier, J., Fortin, S., Déziel, L., Lampron, A., &
Boulanger, M. (2009). Development and evaluation of a shaken
baby syndrome prevention program. JOGNN: Journal Of Obstetric,
Gynecologic & Neonatal Nursing, 38(1), 7-21. doi:10.1111/j.1552-
6909.2008.00301.x.
March, P., & Cabrera, G. (2015). Shaken Baby Syndrome.
Reynolds, A. (2008). Shaken baby syndrome: diagnosis and
treatment. Radiologic Technology, 80(2), 151.
Stoll, B., & Anderson, J. K. (2013). Prevention of Abusive Head
Trauma: A Literature Review. Pediatric Nursing, 39(6), 300-308.
Editor's Notes
SBS med term used to describe…
Violent shaking is one of the most devastating forms of child abuse.
Facts &Figures
Highest rate r/t when babies cry most
Side note: …Infants < 6 mo. of age can cry an average of 2-3 hrs/day
Males: 70% of time
Death: at least 1 in 4
Risk factors for perpetrating SBS
LBW: low birth weight
Colic: intestinal stress/discomfort (manifests as: inconsolable cry)
Top 10 states with highest # of SBS cases:
Ohio
California
New York
Florida
Texas
Pennsylvania
Virginia
Wisconsin
Illinois
North Carolina
Who would want to shake a baby?...
Perpetrators
Anyone has potential to shake a baby, but especially…
Caused by vigorously shaking/striking the head (damage greater if against surface: wall/crib)
Shake baby from torso, extremities, or shoulders
Head rotates uncontrollably due to neck muscles not fully developed
Baby’s brain moves back and forth inside the skull (countrecoup injury)
Bleeding and bruising inside the skull
Forces of ACCELERATION & DECELERATION are very strong
After shaking, swelling in brain can cause pressure in skull
Which increases overall irreversible brain damage
Initially, baby cries more but as brain is damaged, cry less/stop
Complications:
Partial/total blindness
Failure to thrive
Hearing loss
Seizures
Developmental delays
Speech & learning disorders
Problems with memory and attention
Mentally challenged
Cerebral palsy
Paralysis
Coma
Death
Agree with National Center on Shaken Baby Syndrome (NCSBS)
1 out of every 4 children who is shaken dies from their injuries
80% of survivors suffer permanent damage
An estimated 1,000-3,000 children in the U.S. suffer from SBS each year
Good thing: PREVENTABLE
Economic issue:
In the U.S., costs of hospitalizations &continuing care for SBS victims can total betw. $1.2 &$16 billion each yr
Contributions:
Lost wages & productivity of victims who can’t work
Costs of prosecuting the abuser & putting him or her in jail
According to National Center on Shaken Baby Syndrome, 50-75% of teenagers and adults surveyed did not know that shaking a baby is dangerous
B/c of this, detection may be delayed
May not be detected as a baby
May not be detected until school age when health, learning and/or behavior problems start to arise
***Spread understanding that crying is natural part of development, not a problem that is resolved through violence.***
Rules:
Any child abuse/ suspected child abuse must be reported (timely manner)
You CANNOT be held liable for reporting
You CAN be held liable if you did not report & something wrong happens
HELP: National Child Abuse Hotline 1-800-4-A-CHILD
Call 911 right away! Emergency medical care could prevent permanent brain damage, or even save the baby’s life.
Given the absence of national and state registries, no firm statistical data exists, which results in little publicity and funding.
Estimates are rough b/c children with SBS often do not show outward signs of abuse (makes dx difficult)
HCP often miss indicators of SBS
Lack of funding: ultimate barrier to educate the public
Resources limited
Underreported
More programs
PURPLE Crying program
Peak pattern
Unpredictable
Resistant to soothing
Pain-like face
Long bouts
Evening cry
Yes:
Car seat/Car travel
Strollers
BLS/CPR
Some perpetrators of SBS didn’t mean to hurt the child, and did not realize that their actions could have this effect
BE CAREFUL!
When in doubt, REPORT!
Kristen Vital
Nur415 – Selected Health Problems of Women & Children
Shaken Baby Syndrome