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 Mothers 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

Severe
Pupils: dilated, pinpoint or unequal
Blood pooling in eyes
Bulging or spongy forehead or fontanel
Rigidity
Seizures
Respiratory 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 Tips
Check for basic needs: diaper,
hunger
Shushing: rhythmic sounds may
help calm
Sing or talk to baby
Gentle swinging
Never hold a baby while arguing

Other Tips
Check for signs of illness
Call a friend for support
Take for a walk in stroller or car
ride
Never leave baby with someone
you do not trust completely
Check references of caregivers