Shaken Baby Syndrome: Injury and Prevention

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Shaken Baby Syndrome: Injury and Prevention




Guest:  Dr. Kara Blevens – Medically Fragile Children's Program (MFCP)

Host:  Dr. Linda Austin – Psychiatry


Dr. Linda Austin:  I’m Dr. Linda Austin.  I’m interviewing Dr. Kara Blevens who is a pediatrician and Medical Director of the Medically Fragile Children’s Program here at the Medical University of South Carolina.  Dr. Blevens, let’s talk, today, about shaken baby syndrome.  Just what is shaken baby syndrome?


Dr. Kara Blevens:  Shaken baby syndrome is a severe form of head injury that’s generally caused by violent shaking of an infant or a young child generally under two years of age.  This type of injury can occur with as little as five seconds of shaking.  Children in this age group are generally most susceptible to this type of injury because, in general, their brains are softer than older children or adults.  They have weaker neck muscles and, relatively, their heads are larger than the rest of their body, so this type of injury produces a dramatic shearing force on the brain, leading to swelling, bleeding and, many times, permanent injury to the brain, even death, in some cases.  In general, this type of injury is not caused by just gentle bouncing or swinging playfully.


Dr. Linda Austin:  So, it’s really a moment when the parent has just had it from crying or stress in the household, or whatever, picks up the baby, shakes the baby and, boom, you have an injury? How vigorous does that shaking need to be to actually produce damage to the baby?  I mean, obviously, you’re saying no shaking should ever occur to a baby because you can’t gauge that, but are there situations where the parents are just dumbfounded that what seems to them to be a fairly brief or mild shaking actually produces severe trauma?


Dr. Kara Blevens:  Usually not.  Generally, anybody who has witnessed a shaking incident will tell us that it was a violent shaking.  These are not simple gentle shakings.  In many cases, these are not even instances where the child was dropped.  These are instances where the shaking is violent. 


Dr. Linda Austin:  How common is this injury, in the United States?


Dr. Kara Blevens:  It’s hard to say just how common.  We suspect that it’s oftentimes underreported and there’s generally no central registry to report shaken baby syndrome, so it is hard to tell what the incidence is. 


Dr. Linda Austin:  Can there be permanent damage to a child because of this injury. 


Dr. Kara Blevens:  In almost all cases, the injury is permanent.  It can lead to things like cerebral palsy, blindness, hearing impairment and, as I said before, death.


Dr. Linda Austin:  So, it’s quite severe?


Dr. Kara Blevens:  It is severe.


Dr. Linda Austin:  What advice do you have for parents when they get to the point where they just can’t stand the crying anymore?


Dr. Kara Blevens:  I think it’s important for parents to know, number one, that crying is expected, particularly in the first few months of life.  Many babies cry for up to two hours a day.  Some children cry more than others, and it’s important for parents to know that some crying is okay and that if they can’t always fix the crying, sometimes that’s okay also.  The second thing I always like to tell parents is to take a break.  You need to take a break if you are feeling like you are potentially out of control of your emotions or your behavior.  Something as simple as a three to five minute break could save your child’s life. 


The other piece of advice that I offer parents is to know that there are helpful entities, helpful agencies, in the community that can help with information.  There’s 1-800-children which can provide resources, support.  Also, your local pediatrician can be a resource, a support.  Many physicians’ offices are available 24 hours a day and can be a source of support if you feel that you’re a potential risk to your own child, that you might be out of control.


Dr. Linda Austin:  What should a person do if they witness a baby in potential danger?


Dr. Kara Blevens:  That’s a good question.  You would want to report this to medical authorities immediately.  If the child remains in danger, the legal authorities probably also need to be notified.  But the most important aspect of this is to seek medical attention immediately.


Dr. Linda Austin:  And, maybe, just think about, before a mother ever gets to that state, the kind of help and support every mother really needs to get through these very challenging months of early infancy.


Dr. Kara Blevens:  Absolutely.  The American Academy of Pediatrics as well as the Department of Health and Environmental Services is taking large initiatives to educate families and caregivers about these issues in an effort to prevent even one shaken baby episode.


Dr. Linda Austin:  Dr. Blevens, thanks so much for talking with us today.


Dr. Kara Blevens:  Thank you.


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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