Shaken Baby Syndrome
British Columbia Specific Information
A crying baby can become frustrating for parents and caregivers, especially when it goes on for long periods of time or you do not know the cause. To learn about why your baby might be crying, and for tips on what you can do to comfort your child, see HealthLinkBC File #86 Shaken Baby Syndrome, or visit Healthy Families BC - Crying, BC Children’s Hospital – Prevent Shaken Baby Syndrome BC, or The Period of Purple Crying.
If you have any reason to believe a child’s crying is related to possible harm or abuse, call the Helpline for Children toll-free at 310-1234 (no area code needed) or if there is immediate danger call 9-1-1 or your local emergency number. Call 1-866-660-0505 for TTY services for those who are deaf or hearing impaired. The Helpline for Children is a toll-free service, and there is no charge to call the operator if you call from a pay phone. The helpline is available for children, parents, and others who may call to report abuse. For more information, visit Helpline for Children.
Anyone who has reason to believe that a child has been, or is likely to be, abused or neglected has a legal duty under the Child, Family and Community Service Act to report the matter. Visit Ministry of Children and Family Development - Reporting Child Abuse for more information.
What is shaken baby syndrome?
Shaken baby syndrome is brain injury that occurs when someone shakes a baby or throws a baby against an object. It is a form of child abuse. It may happen to children of all ages, but it is most common in babies younger than 1 year old.
It is never okay to shake or throw a child. It may not leave any obvious sign of injury, but it can cause serious long-term problems or even death.
Shaken baby syndrome often occurs when a parent or someone else looking after a baby gets frustrated with the baby’s crying, temporarily loses control, and violently shakes the baby. Parents can help prevent this problem by learning healthy ways to relieve stress and anger. It's also important to choose child care providers carefully.
Shaken baby syndrome may also be called "shaken-impact syndrome." Many doctors use the term "abusive head trauma" to describe the injury.
What causes the brain injury?
When a baby is shaken or thrown, the head twists or whips back and forth. This can cause tears in brain tissue, blood vessels, and nerves. The child's brain slams against the skull. This can cause bleeding and swelling in the brain.
Young children are at high risk for brain injury when they are shaken or thrown. That's because they have:
- Heavy, large heads for their body size.
- Weak neck muscles that don't hold up the head well.
- Delicate blood vessels in their brains.
Normal play, such as bouncing a child on a knee or gently tossing a child in the air, does not cause shaken baby syndrome.
What are the symptoms?
Symptoms vary among children based on how old they are, how often they've been abused, how long they were abused each time, and how much force was used.
Mild injuries may cause subtle symptoms. For example, a child may:
- Be fussy, grouchy, or sluggish.
- Not be hungry.
- No longer smile, make eye contact or babble.
A child with more severe injuries may have symptoms such as:
- Difficulty breathing or a change in breathing pattern.
- A limp body.
- A slow heartbeat.
- Trouble hearing.
- Bleeding inside one or both eyes.
A child who has been shaken or thrown may also have other signs of abuse, such as broken bones, bruises, or burns.
Symptoms can start quickly, especially in a badly injured child. Other times, it may take a few days for brain swelling to cause symptoms.
Sometimes caregivers who harm a child will put the child to bed. They may hope that symptoms will get better with rest. By the time the child gets to a doctor, the child may need urgent care. In some cases, the child may be in a coma before a caregiver seeks help.
How is shaken baby syndrome diagnosed?
Shaken baby syndrome can be hard to detect because often there aren't clear signs of abuse. Instead, a baby may have vague symptoms, such as vomiting or a poor appetite. At first these symptoms may seem related to an infection, such as influenza (flu) or a kidney infection. Sadly, shaken baby syndrome may not be discovered until repeated abuse or more severe harm occurs.
To confirm a diagnosis of shaken baby syndrome, a doctor will:
- Ask about the child's medical history, including when changes in behaviour began.
- Do a physical examination to look for signs of injury and increased blood pressure.
- Do imaging tests such as a CT scan or an MRI to look for bleeding or other injury in the brain.
- Take X-rays to check for broken bones.
A doctor may also do tests to rule out other possible causes of the child's symptoms. For example, a lumbar puncture checks the spinal fluid for signs of meningitis. Blood tests may be done to check for internal injuries or to rule out other conditions, such as rare blood disorders.
A doctor who suspects shaken baby syndrome must report it to the local child welfare office and police.
How is it treated?
A child with shaken baby syndrome needs to be in the hospital, sometimes in an intensive care unit (ICU). Oxygen therapy may be used to help the child breathe. Doctors may give the child medicine to help ease brain swelling. Sometimes a cooling mattress will help lower the child's body temperature and reduce brain swelling.
Depending on the symptoms, doctors may try seizure medicine, physiotherapy, or other treatments. A child who has severe bleeding in the brain may need surgery.
What are the long-term problems from shaken baby syndrome?
A child may have brain damage that causes one or more serious problems, such as:
- Seizures. A baby may have uncontrolled muscle movement and be unable to speak, see, or interact normally.
- Blindness or trouble seeing or hearing.
- Cerebral palsy, with muscle stiffness (spasticity) that results in awkward movements.
- Intellectual disabilities that can affect every area of a child's life. For example, a child may have trouble learning to talk or may not be able to care for himself or herself in the future.
- Learning disabilities that may not appear until the child starts school.
- Emotional or behaviour problems.
Some children die from their injuries.
What should you do if you suspect shaken baby syndrome?
It is important to get help if something doesn't seem right with your baby. Shaken baby syndrome may cause only mild symptoms at first, but any head injury in a young child can be dangerous.
Call 911 or other emergency services immediately if a child:
- Is having trouble breathing.
- Is unconscious.
- Has a seizure.
- Is in immediate danger of further abuse.
Young children can't defend themselves, so it is up to adults who care to protect them. If you suspect abuse and the child is not in immediate danger:
- Call local child protective services or the police.
- Do not confront the person who may have abused the child. This may cause more harm to the child.
Health Tools help you make wise health decisions or take action to improve your health.
Frequently Asked Questions
Learning about shaken baby syndrome:
Other Places To Get Help
Many of the resources below provide help 24 hours a day, 7 days a week in multiple languages. In an emergency, call 911.
- To find a suicide prevention crisis centre phone number or website in your province, visit the Canadian Association for Suicide Prevention's webpage at http://suicideprevention.ca/thinking-about-suicide.
- To find a rape crisis or women's centre phone number or website in your province, visit the Canadian Association of Sexual Assault Centres' webpage at www.casac.ca/content/anti-violence-centres.
- Kids and teens can call Kids Help Phone at 1-800-668-6868 (toll-free 24/7) or visit http://org.kidshelpphone.ca.
- Provincial Health Information Line. HEALTHLink Alberta. Call 1-866-408-5465 (toll-free 24/7) or visit https://myhealth.alberta.ca.
- Family Violence Info Line. Call 310-1818 (no area code required, toll-free 24/7 in Alberta) or visit http://humanservices.alberta.ca/abuse-bullying/14839.html.
- Child Abuse Hotline. Call 1-800-387-5437 (toll-free (24/7) or visit http://humanservices.alberta.ca/abuse-bullying.html.
- Sexual Assault Centre of Edmonton (SACE). Call 780-423-4121 (24/7) or visit www.sace.ab.ca.
- Bully Free Alberta. Call 1-888-456-2323 (toll-free (24/7) or visit www.bullyfreealberta.ca.
- Mental Health Help Line. Call 1-877-303-2642 (toll-free 24/7).
- Addiction Services Helpline. Call 1-866-332-2322 (toll-free 24/7).
- Provincial Health Information Line. HealthLinkBC. Call 8-1-1 (toll-free 24/7) or visit www.healthlinkbc.ca.
- Domestic Violence Helpline. Call 1-800-563-0808 (toll-free 24/7) or visit www.domesticviolencebc.ca.
- VictimLink BC. Call 1-800-563-0808 (toll-free 24/7) or visit www.victimlinkbc.ca.
- Child Abuse Prevention Website: Helpline. Call 310-1234 (toll-free) or visit www.safekidsbc.ca/helpline.htm.
- BC Mental Health and Substance Use Services. Call 310-6789 (tool-free) or visit www.bcmhsus.ca.
- Crisis Intervention and Suicide Prevention Centre of British Columbia. Call 1-800-784-2433 (toll-free 24/7) or visit http://crisiscentre.bc.ca.
- Provincial Health Information Line. Tele-Care 811: Call 8-1-1 (toll free 24/7) or visit www.gnb.ca/0217/Tele-Care-e.asp.
- Emergency Social Services. During regular office hours (Monday to Friday, 8 a.m. to 5 p.m.), visit www2.gnb.ca/content/gnb/en/departments/social_development/about_us/emergency_socialservices.html to find the number for the office nearest you. After hours, call 1-800-442-9799 (toll-free).
- Fredericton Sexual Assault Crisis Centre. Call (506) 454-0437 (24/7) or visit www.fsacc.ca.
- Suicide Prevention CHIMO Helpline. Call 1-800-667-5005 (24/7) or visit www.gnb.ca/0055/index-e.asp.
- Provincial Health Information Line. Telehealth Ontario: Call 1-866-797-0000 (toll-free 24/7) or visit www.health.gov.on.ca/en/public/programs/telehealth.
- Assaulted Women's Helpline. Call 1-866-863-0511 (toll-free 24/7) or visit www.awhl.org.
- Distress Centres Ontario. Visit www.dcontario.org/help.html to find the phone number for a crisis line in your calling area.
- Drug and Alcohol Helpline. Call 1-800-565-8603 (toll-free 24/7) or visit www.drugandalcoholhelpline.ca.
- Mental Health Helpline. Call 1-866-531-2600 (toll-free 24/7) or visit www.mentalhealthhelpline.ca.
- Provincial Health Information Line. HealthLine. Call 811 or visit www.health.gov.sk.ca/healthline.
- Family Violence Outreach. Go to www.justice.gov.sk.ca/FVO for a list of community-based organizations and their contact information, or visit www.justice.gov.sk.ca/IVAP.
- Child Protection. Go to www.socialservices.gov.sk.ca/child-protection.pdf for a list of local child protection offices and their contact information, or visit http://www.socialservices.gov.sk.ca/child-protection.
- Mental Health and Addictions. Go to www.health.gov.sk.ca/treatment-services-directory for a list of local alcohol and drug treatment services and their contact information, or visit www.health.gov.sk.ca/alcohol-and-drug-services.
- Provincial Health Information Line. Yukon HealthLine: Call 811 or visit www.hss.gov.yk.ca/811.php. If you are calling from a satellite phone, you can dial 1-604-215-4700 to reach the Health Services Representative at HealthLink BC.
- Family and Children's Services. Call 1-867-667-3002 or visit www.hss.gov.yk.ca/family_children.php.
- Victim Services. Call 1-800-563-0808 (toll-free). Or visit the Department of Justice "Need Help? Phone Directory" at www.justice.gov.yk.ca/prog/cor/vs/phonedir.html.
- Alcohol and Drug Services. Call 1-855-667-5777 or visit http://.hss.gov.yk.ca/ads.php.
Check your local phone book or provincial or territorial website.
Other Works Consulted
- Saunders BE, et al., eds. (2004). Child Physical and Sexual Abuse: Guidelines for Treatment (Revised). Charleston, SC: National Crime Victims Research and Treatment Center. Also available online: http://academicdepartments.musc.edu/ncvc/resources_prof/ovc_guidelines04-26-04.pdf.
- American Academy of Pediatrics (2007, reaffirmed 2012). Evaluation of suspected child physical abuse. Pediatrics, 119(6): 1232–1241. Also available online: http://pediatrics.aappublications.org/content/119/6/1232.full.
- American Academy of Pediatrics (2008). Promoting mental health. In Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 3rd ed., pp. 77–107. Elk Grove Village, IL: American Academy of Pediatrics.
- Braverman R (2014). Eye. In WW Hay Jr et al., eds., Current Diagnosis and Treatment: Pediatrics, 22nd ed., pp. 447–489. New York: McGraw Hill.
- The Arc (accessed October 2012). Shaken Baby Syndrome. Silver Spring, MD: The Arc. Available online: http://www.thearc.org/page.aspx?pid=2549.
Adaptation Date: 1/20/2017
Adapted By: HealthLink BC
Adaptation Reviewed By: HealthLink BC
Adaptation Date: 1/20/2017
Adapted By: HealthLink BC
Adaptation Reviewed By: HealthLink BC
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