The primary reason for Shaken Baby Syndrome/Abusive Head Trauma (SBS/AHT) is agitation and overwhelming frustration from a crying baby. Men, primarily young fathers or boyfriends in their teens and early 20’s, and caregivers, other than the mother, are more likely to shake a baby out of frustration due to continued crying. Many times these adults are ill-prepared for how to handle a crying baby and lose control when there are many failed attempts to sooth the infant.

Being stressed out, feeling overly tired, having limited self-anger management, feeling inadequate, isolated or depressed, or coming from a family background of abuse are all precursors to being unable to cope with a difficult time while caring for a small child.

Things to do when feeling overwhelmed:

• Be patient, take a deep breath and count to 10.
• Put the baby in a safe place, in the crib on its back, or in a bouncy chair and leave the room.
• Call a friend or relative who can come and give you a break so you can calm down.
• Make sure to take care of yourself by having something to eat and having a glass of water.

Remember that crying is the baby’s only way to communicate its needs. Sometimes they cry for seemingly long periods of time, especially in the late afternoon and the evening and sometimes they cannot be soothed, despite whatever you try. All of these things do not mean that you’re a bad parent. Things will get better and your baby will eventually stop crying. Keep this in mind when you’re going through it right at that moment of the stress of crying.

Things to try to sooth your baby:

• Check for signs of discomfort: check the baby’s diaper, check for diaper rash, see if the baby is teething, and check to see if the baby’s clothing is too tight or scratching the baby in any way.
• Assess when the baby has been fed lately or if the baby needs burping.
• Gently rock the baby, rub its back, offer a pacifier, sing or talk, shush the baby, take a walk with the stroller, put the baby in its car seat and drive around the neighborhood.
• Try turning on the radio, a vacuum cleaner, or a hairdryer for some soothing background noise.
• Bring the baby into a darkened room.
• Try giving the baby a bath or taking it into the shower with you.
• If you are feeling as if nothing else is working, call a doctor to see if there is an unrecognized illness or unseen problem.

Shaken Baby Syndrome/Abusive Head Trauma refers to the typical signs and symptoms that occur from violent shaking of an infant. Shaking the baby or child causes the developing brain to move within the skull resulting in brain tissue damage, the rupture of blood vessels and bleeding around the brain, spinal cord damage, and rupture of blood vessels in the eyes. These damages become life-long and non-reversible, and may even lead to death of the infant.

Screening your child’s caregiver is an important way to ensure that this won’t happen. Find out their skills and what their experiences are with children of this age. Get a police background check on any prospective child care provider.

Choose a center or daycare provider who has been licensed in your state. Find out who all will be attending to your child and what their experiences and backgrounds are. Talk with your childcare provider about shaken baby syndrome and inform them of the ways to sooth a baby and ways to deal with feeling overwhelmed.

• Let your sitter or day care provider know that anytime he or she is feeling overwhelmed and unable to take care of your child, to call you immediately.

A few things to ask your prospective childcare provider about:

• Does the sitter know how to maintain a safe environment?
• Does the sitter understand the limitations of an infant’s physical, emotional, and cognitive abilities?
• What will the sitter do when your baby is feeling fussy, won’t go to sleep, is upset, or cries for a long time?
• Does your sitter have any personal stressors going on in their life?

Possible signs of shaking:

• Lethargy and decreased muscle tone
• Extreme irritability
• Decreased appetite, poor feeding, or vomiting
• No smiling or vocalization
• Poor sucking or inability to swallow
• Difficulty breathing
• Seizures
• Inability to lift head
• Inability to follow an object with the eyes
• Unequal pupil sizes
• The head or forehead is larger than usual or an area seems to be bulging

Long-term effects could include:

• Neurological damage
• Learning difficulties
• Physical disabilities
• Blindness
• Hearing impairment
• Behavior disorders
• Cognitive impairment
• Death

Sources:

Athens Parent Inc. (2003). Shaken Baby Syndrome. Retrieved on 15 April 2012 from: http://www.athensparent.com/articles/pregnancybaby/shakenbaby.html

Centers for Disease Control (2011). Preventing Shaken Baby Syndrome: A guide for health departments and community-based organizations. Retrieved on 15 April 2012 from
http://www.cdc.gov/Concussion/pdf/Preventing_SBS_508-a.pdf

National Center of Shaken Baby Syndrome. Retrieved on 15 April 2012 from: http://www.dontshake.org

The Nemours Foundation (2012). Abusive Head Trauma (Shaken Baby Syndrome). Retrieved on
17 April 2012 from:
http://kidshealth.org/parent/medical/brain/shaken.html

***September 2014 written by Melanie Gray, shared with permission