Shaken Baby Syndrome: An Overview

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Shaken Baby Syndrome: An Overview




Guest:  Dr. Joel Cochran – Pediatrics - Emergency & Critical Care

  Host:  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?


Dr. Joel Cochran:  The shaken baby syndrome is a syndrome that results from the intense shaking of young babies with the resulting trauma to their brain. 


Dr. Pam Morris:  When you say intense shaking to a baby, is there a certain age range of children that are at risk for this syndrome?


Dr. Joel 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.


Dr. Pam Morris:  And does that have to do with the developmental stage of the brain and the soft tissue surrounding the brain?


Dr. Joel 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. 


Dr. Pam 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?


Dr. Joel 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.


Dr. Pam 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?


Dr. Joel 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.


Dr. Pam Morris:  What are some of the signs or symptoms that you look for in diagnosing shaken baby syndrome?


Dr. Joel 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 retina.


Dr. Pam Morris:  Are there more subtle signs, for example, development delay or behavioral evidence shaken baby syndrome?


Dr. Joel 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.


Dr. Pam Morris:  What are some of the treatments for shaken baby syndrome, and are there treatments?


Dr. Joel 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 tragic.


Dr. Pam 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?


Dr. Joel 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 baby. 


Dr. Pam 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.  Thank you.


Dr. Joel Cochran:  You’re very welcome.


If you have any questions about the services or programs offered at the Medical University of South Carolina or if you would like to schedule an appointment with one of our physicians, please call MUSC Health Connection:  (843) 792-1414.



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