1. Shaken Baby Syndrome (SBS)
Image Source: Retrieved January 30, 2012.
Cinthya Vidales, RN, BSN

2. What is Shaken Baby Syndrome (SBS)?
Another name is Abusive Head Trauma (AHT) or Shaken Impact Syndrome (SIS).
This happens when a “frustrated caregiver violently shakes, slams, hits, or punches a child’s head, usually to stop them from crying or to get them to respond to the expectations of the caregiver” (The Shaken Baby Alliance, 2009).
The Shaken Baby Alliance. (2009). What is Shaken Baby Syndrome/Abusive Head Trauma? Retrieved January 30, 2012 from
Image source:

3. What is Shaken Baby Syndrome (SBS)?
The baby’s brain rebounds inside the skull when shaken. This injury will cause bruising of the brain, swelling, pressure, and bleeding (intracerebral hemorrhage). This can easily lead to permanent brain damage or death (Kaneshiro & Zieve, 2011).
Kaneshiro, N. K & Zieve, D. (2011). Shaken Baby Symptoms. Retrieved January 30, 2012 from
Image source:

4. Statistics
SBS is a leading cause of child abuse deaths in the United States.
At least one in four babies dies as a consequence of this form of abuse.
Infants up to 4 months are at greatest risk of injury from shaking
Inconsolable crying is a primary trigger for shaking a baby.
Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. (2010). Heads Up: Preventing Shaken Baby Syndrome- Guide for Health Departments and Community Based Organization. Retrieved January 31, 2012 from
CDC, 2010

5. Statistics
It is estimated that approximately 1,000 to 3,000 children suffer from SBS
80 percent of survivors suffer from permanent damage.
the United States, the costs of hospitalization and continuing care for SBS victims can total $1.2 to $16 billion dollars each year.
New York State Department of Health (2010, June). Shaken Baby Syndrome: Facts and Figures. Retrieved February 3, 2012 from
(New York State Dept of Health, 2010)

6. Statistics
It is estimated that perpetrators in 65% to 90% of cases are males — usually either the baby's father or the mother's boyfriend, often someone in his early twenties (KidsHealth, 2012).
Can occur in as little as 5 seconds of shaking (Kaneshiro & Zieve, 2011).
KidsHealth (2012). Abusive Head Trauma (Shaken Baby Syndrome). Retrieved February 6, 2012 from

7. Videos on SBS
related

8. What happens when shaking a baby
3D Simulation of brain injury and hemorrhage
v=l_toKPs9Jj4&feature=fvwrel

9. Shaken Baby Syndrome is a Preventable Public Health Problem!
Remember:
Shaken Baby Syndrome is a Preventable Public Health Problem!
CDC, 2010

10. What are the signs?
Kaneshiro, N. K & Zieve, D. (2011). Shaken Baby Symptoms. Retrieved January 30, 2012 from
Image source: Retrieved January 30, 2012.
Usually there are no outward physical signs of trauma, but there may be a change in the child's behavior such as irritability, lethargy, pale or bluish skin, vomiting, and convulsions (Kaneshiro & Zieve).

11. Signs May also exhibit limpness in arms and legs or rigidity/posturing
Decreased level of consciousness
Vomiting; poor feeding
Inability to suck or swallow
Changes in feeding and napping patterns
Miehl, N. (2005). Shaken Baby Syndrome: Clinical Presentation of SBS. Medscape. Retrieved January 31, 2012 from

12. Clinical Manifestations
Respiratory difficulty including apnea
Decreased level of consciousness
Seizure activity
Bradycardia
Bulging fontanels indicative of increased intracranial pressure
Possible complete cardiovascular collapse requiring CPR
Miehl, N. (2005). Shaken Baby Syndrome: Clinical Presentation of SBS. Medscape. Retrieved January 31, 2012 from
(Miehl, 2005)

13. Diagnostic Exams
CT scan
MRI scan
Eye examination

14. Clinical Findings Subdural hemorrhage (A)
Retinal detachment/hemorrhage (B)
Image (A) source:
Image (B) source: B A

15. Retinal Hemorrhage
Retinal hemorrhage is a cardinal display of Shaken Baby Syndrome.
Occurs from the repeated acceleration-deceleration forces
Results in vitreo-retinal traction and perhaps damage to blood vessels and nerves behind the eye (orbit)
Essential that ophthalmologists familiar with ocular findings in SBS, evaluate suspected child victims
Levin, A. (2006). Eye Findings in Shaken Baby Syndrome. Retrieved January 31, 2012 from
(Levin, 2006)

16. Subdural Hemorrhage
The brain rotates within the skull cavity, injuring, or destroying brain tissue
When shaking occurs, blood vessels feeding the brain can be torn, leading to bleeding around the brain.
Blood pools within the skull, sometimes creating more pressure within the skull and possibly causing additional brain damage.
The National Center on Shaken Baby Syndrome (n.d). “Long-Term Consequences”. Retrieved January 31, 2012 from
The National Center on Shaken Baby Syndrome, (n.d)

17. Long-Term Consequences:
Learning & Physical disabilities
Visual disabilities or blindness
SBS survivors may have long term visual compromise. The main cause is brain injury to the vision centers (occipital lobes) and direct optic nerve injury. 
Hearing impairment
Cognitive impairment
Speech disabilities
Cerebral Palsy
Seizures
Behavior disorders
Death
The National Center on Shaken Baby Syndrome (n.d). “Long-Term Consequences”. Retrieved January 31, 2012 from
The National Center on Shaken Baby Syndrome, (n.d)

18. Tips for Parents
It is important to educate parents and caregivers about the dangers of SBS. Anyone caring for a child should know that if a baby is not uncomfortable or sick but will not stop crying, it is okay to put the baby down in a safe place (like a crib) and take a short break to relax.
• New parents should know that it is common for babies to cry for up to three hours a day – some cry even more than this.
•Some states such as New York have legislation requiring that hospital maternity wards offer to show new parents a video on shaken baby syndrome before they leave the hospital.
• If you suspect a baby has been shaken, you should call 911 or take the baby to the closest hospital emergency room.
(New York State Dept of Health, 2010)
New York State Department of Health (2010, October). Shaken Baby Syndrome: Facts and Figures. Retrieved February 3, 2012 from

19. Tips for Parents Kaneshiro & Zieve, 2011
NEVER shake a baby or child in play or in anger. Even gentle shaking can become violent shaking when you are angry.
Do not hold your baby during an argument.
If you find yourself becoming annoyed or angry with your baby, put him in the crib and leave the room. Try to calm down. Call someone for support.
Call a friend or relative to come and stay with the child if you feel out of control.
Contact a local crisis hotline or child abuse hotline for help and guidance.
Seek the help of a counselor and attend parenting classes.
Do not ignore the signs if you suspect child abuse in your home or in the home of someone you know.
Kaneshiro & Zieve, 2011

20. NEVER NEVER NEVER
SHAKE A BABY!!!

21. Further Study Click on the following link to read more on SBS

22. Quiz
Please follow the link on the website to take the quiz on Shaken Baby Syndrome.
At the end of the quiz you will be able to see the correct answers.

23. References
Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. (2010). Heads Up: Preventing Shaken Baby Syndrome- Guide for Health Departments and Community Based Organization. Retrieved January , 2012 from
Kaneshiro, N. K & Zieve, D. (2011). Shaken Baby Symptoms. Retrieved January 30, from
KidsHealth (2012). Abusive Head Trauma (Shaken Baby Syndrome). Retrieved February 6, 2012 from
Levin, A. (2006). Eye Findings in Shaken Baby Syndrome. Retrieved January 31, from topNavID=3&subNavID=25&navID=279

24. References:
Miehl, N. (2005). Shaken Baby Syndrome: Clinical Presentation of SBS. Medscape. Retrieved January 31, 2012 from
New York State Department of Health (2010, October). Shaken Baby Syndrome: Facts and Figures. Retrieved February 3, 2012 from sbs_fact_sheet.pdf
The National Center on Shaken Baby Syndrome (n.d). “Long-Term Consequences”. Retrieved January 31, 2012 from topNavID=3&subNavID=23
The Shaken Baby Alliance. (2009). What is Shaken Baby Syndrome/Abusive Head Trauma? Retrieved January 30, 2012 from

25. Videos
Missouri Department of Health and Senior Services. (2011 Oct 10). Never Shake: Preventing Shaken Baby Syndrome. [Video file]. Retreived February 9, 2012 from  v=M3xytsg6oDo&feature=related
New Mexico Aging and Long-Term Services Department. (2010 Nov 10). TBI in Young Children 4: Shaken Baby Syndrome and Normal Infant Crying. [Video file]. Retrieved February 3, from 
Oopshansoo. (2010 Mar 17). Shaken Baby Syndrome 3D. [Video file]. Retrieved February 3, from 
Tavares, S. (2008). The Rupture of Bridging Veins in Shaken Baby Syndrome. [Video file]. Retrieved February 3, 2012 from