How do physicians diagnose shaken baby syndrome?
A classic triad most commonly seen consists of (1) single or multiple subdural hematomas (localized bleeding outside of the brain substance), (2) diffuse and multi-depth retinal hemorrhages, and (3) diffuse brain injury without a reasonable explanation for such severe (and often repeated) trauma. Several agencies, including the American Academy of Pediatrics, recommend that the term shaken baby syndrome be replaced with abusive head trauma. Such a change broadens the various mechanisms of injury commonly seen besides shaking. Blunt head trauma is commonly seen in addition to shaking. Common mechanisms of direct blows to the head include punching the infant, hitting the head or face with a hard object (for example, wooden spoon), or slamming the infant’s head against the wall or floor.
What are complications and long-term effects of shaken baby syndrome?
Neurologic side effects of either shaking or blunt skull trauma may span from developmental delays, seizure disorders, visual impairment, and blindness to death. Orthopedic consequences of inflicted trauma range from the need for recurrent surgery to permanent loss of function if the back (and thus spinal cord) is involved. Scarring of the skin is a common side effect of inflicted burns. Plastic and reconstructive surgery may be necessary depending on the nature of the trauma (for example, immersion into hot water). Emotional side effects may be obvious or subtle and may not necessarily be present or detectable at the time of diagnosis. Counseling and psychological support and intervention may require repeated or long-lasting attention.
What is the prognosis of shaken baby syndrome?
The primary predictor for an optimal prognosis is establishing the diagnosis and thus removing the child (and any siblings) from the abusive home. The nature of these neurological injuries help shape realistic prognostic expectations. The “plastic” nature of the immature brain and peripheral nervous system allow those counseling caregivers of children who have sustained shaken baby syndrome to be more optimistic than those counseling after adult traumatic brain injury. One study found that approximately one-third of those who suffered abusive head injury have no discernable side effect; unfortunately, such a statistic implies that two-thirds of such victims will have residual long-term complications.
Is it possible to prevent shaken baby syndrome?
Many studies have determined that what is felt to be incessant crying is the primary stimulus leading to a frustrated caregiver losing control. Expectant parents must be counseled regarding the nature of crying and various management strategies for both the infant and themselves. It is important to underscore that many times there is no obvious or discernable cause for the infant’s crying. Likewise, it is important for parents and all caregivers to understand that allowing an infant to cry for a reasonably short period (10-15 minutes) does not lead to short- or long-term physical or emotional-health issues. Most importantly, those caring for children must be assured that asking for help is an excellent strategy when they find themselves “at the end of their rope.”
Scott Juceam is one of the leading advocates against Shaken Baby Syndrome. Scott’s life changed when his daughter Hannah was shaken to death by her nanny in 2006. Since then, Scott has dedicated his life to preventing Shaken Baby Syndrome and child abuse.