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Shaken Baby Syndrome by JOHN A. BRENNAN, M.D. A four-week-old male, “Jeremiah,” is brought to the Emergency Department after one hour of seizing. Jeremiah requires many doses of intravenous medications to stop the seizures and is placed on a respirator to help him breathe. He shows no outward signs of trauma, nor had he been ill. His mother states that she had been out shopping for three hours while her boyfriend cared for the infant. She returned home at 2:00 PM to find Jeremiah seizing. She immediately called 911.
The skull is a rigid base covering the brain. Within the skull a fluid cushions the brain and brings nutrients to the brain cells. An infant’s brain essentially floats in this fluid surrounding it. When an infant is shaken the brain is accelerated forward and backward. Not only is the brain “banged” against the inside of the skull, a tremendous shearing force is created. The brain becomes “bruised” and areas of the brain begin to bleed. The trauma causes either death or permanent injury to the brain. If these children survive, they suffer permanent learning and development disabilities as well as seizure disorders. It is important to note that the shaking of an infant is not always a violent action. A little force can have serious repercussions, with a devastating effect on the child. The advances in medical technology have allowed us to diagnose the “shaken baby syndrome” much more frequently and accurately. CT scans and MRI brain scans are very sensitive. The signs and symptoms to watch for are irritability, seizures, vomiting, lethargy, decreased appetite and, on exam, retinal bleeding. We must now take this information and educate parents and other child caregivers on the dangers of shaking a baby. We need to provide caregivers with the proper parenting education and tools as well as give parents ways to cope with stressful parenting situations. Together we can reduce the number of traumatic deaths due to the shaken baby syndrome. Epilogue: Jeremiah was eventually admitted to the Pediatric Intensive Care Unit. After a very rocky course he was discharged one month later. Jeremiah is now one year old and despite two anti-seizure medications, he still has at least three seizures per day. Furthermore, he has significant developmental delays. The mother’s boyfriend eventually admitted shaking Jeremiah. The baby had been crying for 20 minutes straight. At his wit’s end––having tried many ways to quiet Jeremiah––he shook him. The boyfriend is serving a two-year jail sentence. [ top ] |
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Trauma is the leading cause of death in children between the ages of one month to four years. The shaken baby syndrome is one of the most preventable causes of traumatic death in children. Few people understand the seriousness of this type of child abuse. Public education concerning the shaken baby syndrome must become a high priority. 
