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Handle With Care

Dealing With Shaken Baby Syndrome

By Kelly Burgess

Although she admits this isn't a scientific classification, Armstrong says she divides people who shake a baby into two categories: shakers and shaker/beaters. "A 'shaker' is someone who, out of frustration over a crying baby, just begins to shake the child," says Armstrong. "They admit it immediately and get immediate help for the baby and then try to get help for themselves. A 'shaker/beater' is someone who is an ongoing child abuser. They may have been beating that child for a while, but no one catches on until they hurt the baby so horribly that it has to go to the hospital and all the old injuries turn up."

The statistics bear out her unscientific classifications. In fact, in most cases the shaker is a child's natural parent. Adult males in their early 20s, who are the baby's father or the mother's boyfriend, are typically the shaker. Females who injure babies by shaking tend to be baby-sitters or childcare providers. Mothers are the shakers in only 10 percent of the cases. Most experts agree that a crying baby is the most common trigger for shaking.

A baby's brain, along with the blood vessels connecting the skull to the brain, is fragile and underdeveloped. When a baby is shaken, the brain ricochets about the skull, causing the blood vessels to tear away and blood to pool inside the skull.

Unfortunately, it's common for someone who shakes a baby to have a stronger instinct for self-preservation than a desire to save the baby. Out of fear of punishment, they will often not seek treatment right away. By the time someone else does, or an obviously gravely ill child finally drives them to it, the damage is irreversible.

Some of the signs and symptoms of shaken baby syndrome are poor appetite, vomiting, lethargy, irritability, seizures, pale or bluish skin and coma-like sleep. Upon examining the baby, medical personnel look for a variety of factors that point to SBS. One of the most common in shaken babies is a retinal hemorrhage. Although they are common in most types of child abuse, the incidence in shaken baby cases is so high that it is nearly always considered an SBS case.

Prevention

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• Talk about it!

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