Shaken Baby Syndrome

And why prevention is important:

by Harshani A. Pinnawala

What happens when parents and caregivers lose control of themselves while putting a child to sleep or shaking them to stop them from crying or throwing them about during an emotional outburst?

These actions of a few seconds might lead to bruises, bone fractures and significantly, a permanent health issue identified as Shaken Baby Syndrome (SBS). Infants who are below 1 year are more prone to this syndrome, although this can be seen in children up to the age of 5 years as well.

The term may vary due to the method of SBS such as abusive head trauma, shaken impact syndrome, whiplash shake syndrome and inflicted head injury. However, this is a traumatic injury occurring to the brain of an infant or toddler due to abuse.

Infants suffering from SBS have heads larger than the rest of their body, and their neck muscles are comparatively weak, which makes it difficult to support their heads. Aggressive shaking of infants also causes serious damages to the brain tissues.

Symptoms:

Symptoms of SBS might commence within several days (2-3) in a badly injured infant, or may not be immediately visible. These symptoms might vary due to age, number and length of abusive episodes and the degree of force used.

Mild injuries may cause subtle symptoms such as being fussy, rigid, glassy eyes, unable to lift the head, or focus on an object, lethargy, and extreme irritability, difficulty in staying awake, body tremors, breathing difficulties, discoloured skin, vomiting, poor eating habits and problems in feeding.

The long term consequences of infants who are exposed to SBS and harsh injuries are severe damages occurring in the brain, which might lead to eye damage such as bleeding inside the eyes and or complete blindness, hearing impairment, speech problems, damage to the neck and spinal cord, learning disabilities (issues related to understanding or using spoken or written language), intellectual disability (difficulties in learning to talk and or not being able to take care of themselves in later years), emotional setbacks, behavioural problems, paralysis (permanent vegetative state), developmental problems, seizures (rapid abnormal electrical activities in the brain), slow heartbeat and cerebral palsy (awkward movements due to muscle stiffness).

Treatment:

In most severe cases, this might lead to a coma situation (unconsciousness) due to the severity of the brain injury, even resulting in permanent loss of lives.

Is SBS curable? The answer is definitely 'no'. Moreover, on a negative note for this syndrome, SBS cannot be discovered if the symptoms are mild. It might even be misinterpreted as an infection or normal fever or kidney problem.

However, once a diagnosed infant is hospitalised, the medical trainers might use various techniques to lower the damage such as dispensing medicine to reduce brain swelling, providing cooling mattresses to lower the body temperature and reduce brain swelling and oxygen therapy to increase the breathing.

Prevention:

To discover the irreversible injuries in the brain, an infant might need to be subjected to various tests such as computerised tomography (CT), scan magnetic resonance imaging (MRI), skeletal survey ophthalmological exam and blood tests.

A diagnosed infant might need to undergo brain surgery and be put on lifelong medical care for hearing difficulties, development delays, learning problems, seizures, coma and cerebral palsy.

Additionally, a child may seek help from counsellors or psychologists for a period of time to overcome the traumatic events, which will again have an impact while exploring the history.

The probability of increasing the risk factors occurring in SBS are mostly related to parents and caregivers. Young and single parenthood, domestic violence, consumption of alcohol, unstable family situations, unrealistic expectations of children, street levels, depression and other psychological problems can be the reasons for mistreating children.

As an example, if one or both parents are exposed to mistreatment as a child, there is a tendency for repeating the same to his/her child. This can be seen in men than in women.

Nevertheless, SBS can be prevented by following certain precautions such as not leaving children with unknown caregivers, and if this cannot be avoided, make them aware about the severity of SBS.Furthermore, it is better to leave the child behind for a period time, if the parents are not in a situation to control their anger while feeding or putting to sleep.

Parents who are at a risk of harming their child need to seek help from counsellors/psychologists.

Parents or the caregivers need to protect their children. For, once the SBS occurs, the damage is done forever.