Shaken Baby Syndrome (SBS)

• AKA

–Abusive Head Trauma

–Closed Head Injury

–Blunt Force Trauma to the Head

–Non-Accidental Head Injury

SBS Statistics• Incidence: 1000-1500 cases per year

– 25% of these infants die due to injuries

• Victims are usually less than 1 year old

• More than 60% of victims are Male

• 80% of the Perpetrators are Male

– 50% Natural Parents

– 17% Non- Relatives

– 17% are Mother’s Boyfriend

Vulnerable Population• Physical Dependence

– Can easily be picked up and shaken

• Total Dependence– Dependent on caregivers for food, comfort,

safety

• Social Isolation– Too young to attend school

• Anatomy and Physical Development– Weak neck muscles/unable to support head

Long Term Effects• Of those that Survive

– 1/3 suffer severe disabilities:

• vegetative state

– 1/3 suffer serious disabilities: • Severe seizure disorders, Cerebral Palsy,

paralysis, blindness, inability to live independently

– 1/3 life long disabilities:

• Speech and Learning disabilities, visual and hearing disorders

What is SBS?

• Someone Forcefully Shakes a Baby

• Uncontrolled Head Rotation

• Brain violently moves back and forth in the skull

• Ruptured blood vessels, nerves, and tearing of brain tissue

• Bruising and Bleeding in the brain

Symptoms of SBS

• Severity of injuries dependent on the duration, force, number of episodes and whether blunt impact is involved

• May appear immediately and usually peak within 4-6 hours of the shaking

Signs and Symptoms

• Mild– Lethargy – Decreased muscle tone– Irritability– Poor feeding, poor suck, poor swallowing– Vomiting– Lack of socialization: smiling, cooing, making

sounds– Unable to lift or turn head, turned to one side

Signs and Symptoms

SeverePupils: dilated, pinpoint or unequalBlood pooling in eyesBulging or spongy forehead or fontanelRigiditySeizuresRespiratory Difficulty

Red Flag Warning

Rotational Force Trauma

Subdural Hematoma

Retinal Hemorrhage

Cerebral Edema

Other Injuries

• Hypoxic injury to the brain

• Chemical substances released in the Brain

• Spinal cord and Neck injuries

• Skull Fractures

• Other Bone Fractures

Prevention of SBS

• Education

• Support Systems

• Coping Mechanisms

• Stress Release

Education

• Increased Awareness

• Kimberlin West Act of 2002

• Period of Purple Crying– National Center on Shaken Baby Syndrome– Evidence demonstrates crying is the most

important stimulus for SBS

Kimberlin West Act

• Requires hospitals, birthing centers or home birth providers to give new parents informational brochures about the danger of shaking babies

• Department of Health must prepare and provide these brochures

• Training sessions to teach nurses to talk to new parents about SBS

Purple Period of Crying

• It approaches prevention through child development education about normal infant development, specifically, about crying in normal infants, rather than being limited to warnings of the negative consequences of shaking

• It is a positive program that gives all parents encouragement that aims to improve their relationship with their baby

• The PURPLE program is designed to educate parents

and others about the normal properties of early infant crying, and to reduce the stress and frustration parents experience when they have a baby who cries.

Purple Crying• Peak pattern (crying peaks around 2 months,

then decreases)• Unpredictable (crying for long periods can come

and go for no reason) • Resistant to soothing (the baby may keep crying

for long periods)• Pain-like look on face• Long bouts of crying (crying can go on for

hours)• Evening crying (baby cries more in the afternoon

and evening)

Purple Crying

Walk, talk, bundle baby

Hand over to someone else

Leave in a safe place for few minutes

Other TipsCheck for basic needs: diaper, hungerShushing: rhythmic sounds may help

calmSing or talk to babyGentle swingingNever hold a baby while arguing

Other Tips

Check for signs of illnessCall a friend for supportTake for a walk in stroller or car rideNever leave baby with someone you do

not trust completelyCheck references of caregivers