Shaken Baby Syndrome

1. Shaken Baby Syndrome

2. Shaken Baby Syndrome (SBS) is the collection of signs and symptoms resulting from the violent shaking of an infant or small child. It is a form of child abuse. In America last year, approximately 1,200 - 1,400 children were shaken for whom treatment was sought. Of these tiny victims, 25 -30% died as a result of their injuries.

3. Shaking a baby violently for even 2-3 seconds can cause bleeding into and around the baby's brain and can destroy brain cells. SBS can be misdiagnosed with accidental trauma due to lack of information An estimated 15% of children have no permanent physical damage from SBS but other effects are not known

4. A baby's head and neck are susceptible to head trauma because his or her muscles are not fully developed and the brain tissue is exceptionally fragile. Head trauma is the leading cause of disability among abused infants and children. When shaking occurs, the brain bounces within the skull cavity, bruising the brain tissue. The brain swells, creating pressure and leading to bleeding at the back of the eye. This can cause blindness. Some blood vessels that feed the brain are torn, which leads to additional brain damage or abnormalities. Blood collects inside the skull, creating more pressure. What happens when a baby is shaken?

9. Lethargy / decreased muscle tone Extreme irritability Decreased appetite, poor feeding or vomiting for no apparent reason Grab-type bruises on arms or chest are rare No smiling or vocalization Poor sucking or swallowing Rigidity or posturing Less Serious Injury

10. Difficulty breathing Seizures Head or forehead appears larger than usual or soft-spot on head appears to be bulging Inability to suck or swallow Inability to lift head Inability of eyes to focus or track movement or unequal size of pupils Paralysis Blindness Brain damage Death Serious Injury

11. How does it happen? Often frustrated parents or other persons responsible for a child's care feel that shaking a baby is a harmless way to make a child stop crying. The number one reason a baby is shaken is because of inconsolable crying. It is estimated that 25-50 percent of parents and caretakers aren't aware of the effects of shaking a baby When a child is shaken in anger and frustration, the force is multiplied five or 10 times than it would be if the child had simply tripped and fallen.

12. When your baby won't stop crying, no matter what you try. You may feel like you are a bad parent or that you are doing something wrong. This can be very frustrating. • Others reasons crying is frustrating: • Your baby cries more than you expected • You worry people will think you have a bad baby • Fear of being a bad parent • Feelings of anger toward you baby • Fear that your life may never be normal again

13. If you feel yourself getting upset or angry, put the baby in a safe place and take a minute to take care of yourself. • Take a break from the sound of the crying • Call a good friend • Listen to some music • Exercise • Remember the crying will come to an end • No matter how mad you get, never shake your baby

14. SUDDEN INFANT DEATH SYNDROME (SIDS)

15. Facts About SIDS Approximately 3,000 babies die of SIDS each year SIDS is the leading cause of death in babies after 1 month of age Most SIDS deaths happen in babies who are between 2 and 4 months old. More SIDS deaths happen in colder months. Babies placed to sleep on their stomachs are much more likely to die of SIDS than babies placed on their backs to sleep. African American babies are 2 times more likely to die of SIDS than white babies. American Indian/Alaska Native babies are nearly three times as likely to die of SIDS as white babies. -National Institute of Child Health and Human Development

16. U.S. Annual SIDS Rate per 1000 Live Births

18. BACK TO SLEEP

19. How to Reduce the Risk of SIDS Place healthy babies on their backs to sleep Use a firm mattress in a safe crib Remove all heavy blankets, fluffy comforters, pillows, and stuffed animals from the baby’s sleeping place Don’t place baby on a waterbed, bean bag cushion, or sheepskin pad Avoid overdressing or overheating the baby Do not allow smoking around the baby Keep the baby’s well child check ups and immunizations on schedule

20. At what age does SIDS usually occur? Most SIDS deaths occur between one month and one year of age. The highest risk period for SIDS is between two and four months. That is why it is so important for parents not to switch their baby from back to tummy sleeping and to make sure child care providers don’t switch either. When the baby is old enough to roll from back to tummy or tummy to back easily on his own, usually at 6 months or greater, the risk of SIDS is greatly reduced. SIDS FAQs What about side sleeping? Side sleeping is not recommended because it is not a stable position for babies. They often roll to their tummy from the side position. Babies should not be propped or wedged in the side position. Devices used to wedge babies in this position have not been tested for safety. Pillows or rolled up blankets used to prop babies on their sides pose a risk of covering the babies face when she moves around during sleep. If I follow these recommendations, can I be sure that my baby won’t die of SIDS? Unfortunately, the answer is no, SIDS sometimes occurs even when all recommendations are followed. Research is continuing to determine the exact cause of SIDS so that screening and prevention may be possible in the future. Parents should remember, though, that SIDS has always been a rare event and, since Back To Sleep, it is even more rare. What about flat or misshapen heads? Newborn’s skulls are soft to allow the growing brain to expand. If a baby spends all his time on his back either in an infant carrier, swing or bed, he may develop a flat spot or a “favorite position”. Parents and other caregivers should rotate the baby’s sleeping position so he doesn’t always face in the same direction. When babies are awake and supervised, they should spend daily time on their tummy. Tummy time promotes neck and shoulder strength and helps the baby develop the ability to roll over and crawl. But what if my baby doesn’t sleep well on her back? Most babies will prefer the position they got used to in the early days of life. However, some parents report that their babies don’t sleep very soundly on their backs. They may startle easy and wake up frequently. Researchers have identified that these are healthy components of normal infant sleep. Parents are encouraged to talk about sleep concerns with their health care providers. What about vomiting and choking? The American Academy of Pediatrics has found no evidence that babies sleeping on their backs are in any greater danger of choking even if they vomit