HealthLinkBC File #86, February 2013

Shaken Baby Syndrome

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• What is Shaken Baby Syndrome?
• Did you know?
• How can I protect my baby?
• Why do babies cry?
• What can you do when your baby won’t stop crying?
• What else can you do if comforting your baby doesn’t stop them from crying?
• Remember – never shake a baby!

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Shaken Baby Syndrome

Shaken baby syndrome is a term used to describe the signs and symptoms resulting from shaking a baby, or from shaking and impacting the head of an infant or small child.

A baby's head is heavy and large compared to the rest of the body and its neck muscles are not strong enough to support the weight of the head. Shaking can cause damage to the brain cells leading to permanent brain damage. It can also tear blood vessels inside the baby’s head and cause bleeding in the brain. Even minor injuries to a baby’s brain can cause lifelong problems.

Shaken baby injuries often happen because a parent, or someone else looking after a baby, gets frustrated with the baby’s crying and temporarily loses control and violently shakes the baby.

These kinds of injuries do not occur in regular interactions when playing gently with a baby.

For example, gentle bouncing an infant on your knee does not cause shaken baby syndrome.

Did you know?

Shaking a baby can cause:

• Seizures
• Blindness or deafness
• Paralysis
• Permanent brain damage
• Death

How can I protect my baby?

An important way to protect your baby is to Always Be Careful – ABC, and to follow the advice listed below:

• Always support an infant’s head and neck.
• Don't toss a baby or young child into the air.
• Learn how to cope with your baby’s crying. Many shaking injuries happen when parents or other caregivers are frustrated by a child’s behaviour. It is better to walk away and regain your composure than to pick up a crying baby when you feel angry or frustrated.
• Talk to others who care for your baby such as babysitters, relatives, and friends about how to safely handle your baby. Make sure they understand that it is more important for the caregiver to be calm than to stop your baby from crying. Let them know that you will be happy to come and get the baby if the crying is too much for them.

Why do babies cry?

Sometimes it is easy to figure out why a baby is crying; sometimes it is not so easy.

Remember that crying is normal, and some babies just cry more than others. Babies can cry because they are hungry, uncomfortable, sick, hurt or they want to be held. It is very normal for a baby who is otherwise healthy to cry a lot for their first few months, sometimes even for many hours a day. At times, this crying will be unsoothable, even when the baby is completely fine and healthy. This behaviour usually ends by about 3 to 5 months of age.

If you are worried, take your baby to your health care provider. It is important to have your health care provider check the baby to be sure nothing is wrong because crying may mean that your baby is not feeling well.

Crying does not mean your baby is being bad or that your baby is mad at you. It does not mean that you are a bad parent. Crying is an annoying sound, it is supposed to be. If it was a pleasant sound, crying would be easy to ignore and the baby’s needs would not be met. Don’t let the crying sound get to you. It is helpful to know this is a developmental stage that all babies go through.

The most important thing to remember is that you and your baby will get through this crying stage and smiles and laughter will replace the crying. It is difficult sometimes, but stay calm and take time out when you need it.

What can you do when your baby won’t stop crying?

It is easy to get frustrated and angry when you are caring for a baby that won’t stop crying. You may be feeling tired, alone or think your efforts are not good enough. Many people feel this way. Remember, this type of crying will most likely come to an end by 5 months.

There is no magic answer that works all of the time with every baby. You may have to try several things before you find out what works best for you when soothing your baby. However, what works today may not work tomorrow. You may want to increase the comforting and soothing responses that you normally do. However, sometimes nothing you do will stop the crying, and that’s okay.

Here are some suggestions that may help comfort your baby:

• Snuggle the baby close to your chest; your heartbeat may comfort the baby.
• Check the baby’s diaper. Keep the baby clean and dry.
• Feed the baby slowly and burp the baby often.
• Wrap the baby in a soft blanket.
• Keep the baby warm and comfortable – but not too hot.
• Do not put the baby in crib or bassinette wrapped in a blanket.
• Provide some soft music or other relaxing sounds.
• Try humming or singing a lullaby.
• Sometimes, the sound of the vacuum cleaner, clothes dryer, fish tank filter or dishwasher helps calm a baby.
• Offer a soother or teething ring.
• Offer a favourite blanket or soft toy while cuddling the baby.
• Provide gentle motion.
• Walk with or rock the baby.
• Use a baby swing if you have one.
• Take the baby for a walk in a stroller.
• Some babies like to go for a car ride. Be sure the baby is safely secured in an infant care seat.

Remember, these things work sometimes and sometimes they will not work at all. Do not be discouraged. It is worth trying but you should not blame yourself or the baby if these things do not work. Crying that does not respond to soothing is a normal stage that does come to an end.

What else can you do if comforting your baby doesn’t stop them from crying?

If the crying is very, very frustrating for you it’s okay to take a break. Gently place the baby in a safe place and leave the room. Take a 10 or 15 minute break to give yourself a chance to calm down. Remember, it is more important to calm yourself before you try to calm your baby. Letting the baby cry for a few minutes is not harmful.

Find someone to help you. Call a friend or relative you can trust. It is important to get away from the baby if you think you might lose control. It is just as important to be sure that the baby will be safe while you are gone. If the crying is constant or louder than usual, or the baby has a fever or is vomiting, go to the hospital or health clinic.

Remember that it’s okay to ask for help. The following people may be able to help:

• Family
• Friends
• Your child’s health care provider
• Parent groups
• Nursing Services at 8-1-1
• Your public health nurse, or
• Call your local hospital or health clinic for other contacts in your community.

Remember – never shake a baby!

Babies have weak neck muscles and heavy heads, so even a few seconds of hard shaking can cause serious damage to babies and small children.

For More Information

For more information on ways to comfort your baby, review the Period of PURPLE Crying® program materials that you received at the hospital. For mothers that did not give birth at a hospital in British Columbia, you will receive the DVD/booklet package from public health.

For more tips and resources in your community, visit www.purplecrying.info.

For more HealthLinkBC File topics, visit www.HealthLinkBC.ca/healthfiles/ or your local public health unit. Click on www.HealthLinkBC.ca or call 8-1-1 for non-emergency health information and services in B.C. For deaf and hearing-impaired assistance, call 7-1-1 in B.C. Translation services are available in more than 130 languages on request.