Shaken Baby Syndrome and TBI: What Parents and
Practitioners Should Know
Emily Kronenberger
Shaken Baby Syndrome (SBS) is a leading cause of disability and death among infants in the U.S. SBS occurs when a child is
powerfully shaken; an abusive action that causes the child’s brain to repeatedly knock against the skull. This rebounding of the
brain may cause severe traumatic brain injury (TBI), internal bleeding, and can often lead to permanent impairment and even
death. In addition, SBS is responsible for a host of injury-related chronic health problems including blindness, psychological
trauma, and seizures.1
Identifying SBS in children is challenging because the incidents of injury are likely to happen before the child is capable of
verbally describing discomfort and particular symptoms.2 This delay in diagnosis is not conducive to positive pediatric patient
outcomes because “early recognition and prompt medical management” is vital.3
Identification of SBS is also difficult due to the lack of awareness among parents and/or failure to report abuse. According to a
survey conducted by the Child Abuse Prevention Council (CAPC), 25% to 50% of parents and primary care-givers did not know
that shaking a baby may cause irreparable damage and even death. Researchers at CAPC also report that 80% of people who
shake babies are men. In 1998, CACA recorded 337 deaths as a result of SBS.4
Parents: According to the National Center on Shaken Baby Syndrome, parents and caregivers should immediately seek medical
attention if they suspect a child has been shaken. The following symptoms can be indicative of traumatic brain injury:
-Lethargy/ decreased muscle tone
-Extreme irritability
-Decreased appetite/random vomiting
-No smiling/vocalization
-Inability to suck or swallow
-Difficulty breathing
-Bruising and/or swelling on head
-Inability to lift head
-Inability to focus, unequal size pupils, vision impairment
Physicians: The National Center on Shaken Baby Syndrome recommends the following to physicians where it is possible that
SBS and/or TBI have occurred in a patient:
-Be alert for signs of trauma (abrasions, bruises, abnormal
behavioral patterns)
-Perform a complete physical examination
-When performing a spinal tap, check for signs of previous
-Consult pediatric radiologists when necessary
1 NINDS Shaken Baby Syndrome Information Page. 3/172005.
2 “Abusive Head Trauma can be Difficult for Physicians to Recognize.” National Center on Shaken Baby Syndrome. 3/17/2005. Trauma.
3 Smith, Julie. “Shaken Baby Syndrome.” Orthopaedic Nursing, 2003, Vol. 22, Issue 3: 196-206.
4 “Campaign to Raise Awareness of Shaken Baby Syndrome.” Inside Tuscon Business; 4/3/2000, Vol. 10, Issue 2: 3-5.
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