Shaken Baby Syndrome

Symptoms

Symptoms of shaken baby syndrome may appear right away or within several days. The child's age, the number of abusive episodes, and degree of force used are the main factors that affect when symptoms appear and how severe they are. Trust your instincts if something doesn't seem right with your child.

Mild or vague symptoms

Vague symptoms may include irritability, sluggishness, vomiting, and a poor appetite. At first, caregivers and doctors may assume that these symptoms are related to a common illness such as the flu. If these symptoms are more severe, meningitis may be suspected.

Severe symptoms

In the most severe cases, a child loses consciousness or stops breathing right after being shaken or thrown. The caregiver may attempt to perform cardiopulmonary resuscitation (CPR) and later claim that the CPR caused the child's injuries. The caregiver responsible for the abuse may put the child to bed, hoping the condition will improve after the child rests. By the time the caregiver seeks medical attention, the child may be comatose and unable to suck, swallow, smile, make sounds, or follow the movement of an object with his or her eyes. The child may also have great difficulty breathing or may completely stop breathing, have a slow heart rate, and require CPR. These children usually either die or have long-lasting problems from severe brain injury.¹

Other symptoms

Bleeding inside one or both eyes is a common symptom of shaken baby syndrome that can be detected by a pediatric eye specialist (ophthalmologist). Also, a child may have broken bones, often in the ribs or arms and legs, from violent shaking. Sometimes a child will have signs of other types of physical abuse, such as bruises or burns.

Long-term problems

About 20% to 25% of children who are forcefully shaken or thrown die from their injuries.¹ Those who live may have brain damage and one or more of the following problems:¹

• Blindness, or trouble seeing or hearing
• Seizures, which are sudden bursts of abnormal electrical activity in the brain. A baby may have uncontrolled muscle movement and be unable to speak, see, or interact normally.
• Inability to move (paralysis)
• Mental retardation that can affect every area of a child's life, such as learning to talk or being able to care for himself or herself in later years
• Learning disabilities, which are problems related to understanding or using spoken or written language
• Emotional difficulties or behaviour problems

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Author:	Debby Golonka, MPH	Last Updated: May 9, 2007
Medical Review:	Adam Husney, MD - Family Medicine Michael J. Sexton, MD - Pediatrics Andrew Swan, MD, CCFP, FCFP - Family Medicine
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