Shaken Baby Syndrome: An Overview
Joel Cochran – Pediatrics
- Emergency & Critical Care
Dr. Pam Morris – Cardiology
Dr. Pam Morris:
Hi. I’m Dr. Pam Morris and I’m
here today with Dr. Joel Cochran who is Associate Professor of Pediatrics and
Medical Director of the Pediatric Intensive Care Unit at the Medical University
of South Carolina. We’re talking, today,
about the shaken baby syndrome. Dr.
Cochran, could you define the shaken baby syndrome for us?
Cochran: The shaken baby syndrome is a
syndrome that results from the intense shaking of young babies with the
resulting trauma to their brain.
Morris: When you say intense shaking to
a baby, is there a certain age range of children that are at risk for this
Cochran: Usually, it’s in children that
are less than a year of age. It can
happen in kids that are a little bit older but, mostly, it’s in kids that are
less than a year.
Morris: And does that have to do with
the developmental stage of the brain and the soft tissue surrounding the brain?
Cochran: Yeah, it has to do with the
susceptibility of the brain at that age to tearing of blood vessels and things
like that when they’re shaken.
Morris: When you describe the action of
shaking, how hard would a parent or an adult have to shake a child in order to
sustain these injuries?
Cochran: Well, I think in a younger
baby, there’s probably less shaking that would be involved. But in an older child, because their brain is
more developed, more shaking would be needed to cause damage. But any shaking at all of a violent nature to
a child over any period of time, whether it’s seconds to a minute, can be
potentially damaging to a child.
Morris: So, even something as simple as
a frustrated parent grabbing a baby by the shoulders or shaking out of
frustration could result in these injuries?
Cochran: It certainly could, and we
encourage parents to just walk away.
But, it would take some intense shaking to cause damage. But, again, in smaller babies, even a small
amount of shaking can potentially cause damage to that child.
Morris: What are some of the signs or
symptoms that you look for in diagnosing shaken baby syndrome?
Cochran: It’s interesting, in that there
are usually no outward signs. In other
words, there’s no bruising or evidence of any trauma to the child. Usually, we see the damage on a CAT scan of
the brain. Then, oftentimes, what we’ll
do is we’ll see bleeding in the back of the eye, the part of the eye called the
Morris: Are there more subtle signs, for
example, development delay or behavioral evidence shaken baby syndrome?
Cochran: Long-term there would be. Short-term, it can be an acute
life-threatening event, such that the baby could have seizures, stop breathing,
blood pressure problems, essentially, have such damage that they die from
this. The long-term issues are just that
they could have developmental issues.
They could have issues with not being able to see. So, a whole range of, kind of, neurological
problems can develop if the baby survives the incidents of shaking.
Morris: What are some of the treatments
for shaken baby syndrome, and are there treatments?
Cochran: Well, unfortunately, when I
seen them in the intensive care unit, they’re critically ill, so it’s the
treatment that we would give anybody who is critically ill, whether it’s
breathing for the baby using a breathing machine, trying to support the baby’s
blood pressure, treating any seizures that might occur. But, unfortunately, with the brain, once the
damage is done, it’s done. You can try
to prevent further damage from occurring, but whatever damage that occurred
when the baby was shaken, that damage is permanent. The hope and prayer, of course, is that the
baby’s young enough to potentially, kind of, overcome some of those
problems. But, oftentimes, these babies
are devastated and aren’t able to walk or talk or feed themselves and it’s very
Morris: Dr. Cochran, if you’re in the
room with new parents of young babies, how would you counsel those parents to
help them to avoid the devastating consequences of shaken baby syndrome?
Cochran: I think the most important
thing is to realize that everybody gets frustrated with young babies and
everybody gets to the point where they’re just very upset. If you can’t console your child and feel
yourself getting more and more angry, I think the best thing to do is to just
put the child down on the bed or in the crib and just walk away. Let the child cry for a little bit, just walk
away, walk around the room for a little bit, walk downstairs, go get a glass of
water. Then, when you’ve calmed down, go
back and try to console the baby. Don’t
take your frustrations out on the
Morris: Well, I think this is good
advice for adults dealing with adults as well.
Dr. Cochran, thank you so much for joining us today to talk about shaken
baby syndrome and ways to avoid it.
Cochran: You’re very welcome.
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