What Is Shaken Baby Syndrome?

Shaken Baby Syndrome (SBS) is a form of Abusive Head Trauma (AHT) that occurs when a frustrated caregiver causes blunt force trauma to a child’s head by violently shaking and/or impacting the child with or against an object, usually to stop him/her from crying. This blunt force trauma can cause damage to the brain and often to the eyes.

Common diagnostic findings related to this form of child physical abuse include:

  • Subdural hematoma
  • Retinal hemorrhages
  • Cerebral edema (brain swelling)
  • Fractures (rib, skull, long bones)
  • No outward appearance of injury

It is diagnosed through a triad of:

  1. History
  2. Physical
  3. Lab and Imaging Studies

Effects Of Shaken Baby Syndrome On The Brain

Normal child’s brain
MRI scan of child's brain after becoming a Shaken Baby Syndrome Victim
Top view of child’s brain after becoming a Shaken Baby Syndrome Victim
Mid view MRI Scan of child's brain after becoming a Shaken Baby Syndrome Victim
Mid view of child’s brain after becoming a Shaken Baby Syndrome Victim

Thousands of children each year are victims of SBS/AHT/blunt force trauma injuries. The Centers for Disease Control and Prevention (CDC) identifies SBS as “a preventable and severe form of physical child abuse that results in an injury to the brain of the child” (1) . Among infants and young children who are victims of child physical abuse, SBS/AHT is the most common cause of death and long-term disability (2). The American Academy of Pediatrics (AAP) reports an estimated incidence of 32 to 38 cases per 100,000 children per year in their first year of life, of which many go unreported (3).

As a violent injury that presents with a spectrum of signs and symptoms that may range from subtle to obvious, the AAP adds in its 2020 policy statement, Abusive Head Trauma in Infants and Children:

“Failure to recognize AHT and respond appropriately at any step in the process, from medical diagnosis to child protection and legal decision-making can place children at risk.” (4)

Ultimately, nearly 25% of SBS/AHT victims die from the abuse and approximately 70% of survivors suffer some degree of permanent neurologic impairment, including static encephalopathy, intellectual disability, cerebral palsy, cortical blindness, seizure disorders, behavior problems, and learning disabilities (5).

The most common triggers for this form of child physical abuse include (6) :

  • Crying
  • Potty training
  • Feeding issues
  • Interrupting an activity of the caregiver

Dr. Suzanne Starling studied the relationship of the perpetrators to their victims and found that fathers are responsible for the injuries 37% of the time, boyfriends of the mother 20.5%, female babysitters 17.3%, mothers 12.6%, and others 12.6% (7).

Prevention of child physical abuse is a vital part of our mission. The Shaken Baby Alliance has developed a child abuse prevention program entitled When Babies Cry…We C.O.P.E. is based on research and practice by Dr. Mark Dias, a pediatric neuro-surgeon (8).  The State Bar of Texas Committee on Abuse and Neglect funded the initial stage of this important child abuse prevention program by providing needed funding to develop a video entitled When Babies Cry.  This educational program equips community members, new parents, and middle/high school students (i.e., future parents and caregivers) with the tools to cope with a crying baby, the number one trigger for SBS/AHT. When Babies Cry…We C.O.P.E. will provide new and future parents with a structured educational program regarding infant crying patterns, the dangers of violent shaking, and ways to cope with infant crying, including a crying plan and Letter of Promise signed by the caregiver to reduce the incidence of SBS/AHT.  For more information on preventing child physical abuse,  click here.

The Shaken Baby Alliance was founded by three mothers whose children were diagnosed with SBS. Our world was shattered into a million tiny pieces on the day our children were rushed to the hospital and we learned the term, “Shaken Baby Syndrome”.

We faced the disbelief that the person we trusted most to care for our children and keep them safe, was the person who hurt our child. It was frightening to see our innocent babies fighting for their lives while connected to medical equipment we did not understand.

We were fortunate to find each other to lean on for support. We promised our children we would make things better for other family members and we are keeping this promise. Our mission reflects this promise. If you need support, please contact us.

Works Cited

(1) “Preventing Abusive Head Trauma in Children|Child Abuse and Neglect|Violence Prevention|Injury Center|CDC.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 15 Mar. 2021, www.cdc.gov/violenceprevention/childabuseandneglect/Abusive-Head-Trauma.html.

(2) “Shaken Baby Syndrome.” AANSwww.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Shaken-Baby-Syndrome.

(3) Abusive Head Trauma in Infants and Childrenpediatrics.aappublications.org/content/pediatrics/145/4/e20200203.full.pdf?download=true.

(4) Abusive Head Trauma in Infants and Childrenpediatrics.aappublications.org/content/pediatrics/145/4/e20200203.full.pdf?download=true.

(5) Abusive Head Trauma in Infants and Childrenpediatrics.aappublications.org/content/pediatrics/145/4/e20200203.full.pdf?download=true.

(6) Joyce, Tina. “Pediatric Abusive Head Trauma.” StatPearls [Internet]., U.S. National Library of Medicine, 19 Apr. 2021, www.ncbi.nlm.nih.gov/books/NBK499836/.

(7) Starling, Suzanne P., et al. “Abusive Head Trauma: The Relationship of Perpetrators to Their Victims.” American Academy of Pediatrics, American Academy of Pediatrics, 1 Feb. 1995, pediatrics.aappublications.org/content/95/2/259.

(8) Dias, Mark S., et al. “Preventing Abusive Head Trauma Among Infants and Young Children: A Hospital-Based, Parent Education Program.” American Academy of Pediatrics, American Academy of Pediatrics, 1 Apr. 2005, pediatrics.aappublications.org/content/115/4/e470#BIBL.

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