Understanding and preventing Shaken Baby Syndrome

Help, I nearly shook my baby.

It’s every exhausted parent’s biggest fear; that they’ll lose control and snap. In frustration, they will violently shake their inconsolable baby. And in that single moment, their entire family will be shattered. Sadly, Shaken Baby Syndrome is a reality in too many homes across Australia and it has devastating consequences. It is thought that as many as 90 children will become victims of shaking every year, most often at the hands of the people they trust the most. Babies are six times more likely to die from Shaken Baby Syndrome than they are from drowning.

Understanding the risks of shaking a baby

Shaken Baby Syndrome is a serious brain injury resulting from forcefully shaking an infant or toddler. When a baby’s head is shaken back and forth, their tiny brain hits the inside of their skull; blood vessels inside the head can rupture, causing catastrophic injuries or death.

For those who survive, the resulting brain damage can lead to:

intellectual disability,
speech and learning disabilities,
paralysis,
seizures,
vision loss,
hearing loss,
neck or spinal cord damage, and
broken or fractured bones.

The severity of this damage depends on how long and how hard the baby was shaken, but severe damage can occur in even a few short seconds. Alex V. Levin, MD, MHSc, a US based child abuse paediatrician, says that “about one-third of Shaken Baby Syndrome victims die, one-third suffer permanent mild to severe brain injury that may include vision loss, and one-third recover with little or no apparent long-term damage.”

Shaken baby syndrome: how hard is too hard?

If, like me, you second guessed yourself every time you gently rocked and bounced your baby, or took them for a walk along a bumpy road, rest assured that anything in the course of normal play and activity would be unlikely to cause this kind of damage. When experts talk about Shaken Baby Syndrome, they speak about vigorous, back and forth motions. Trauma is usually a result of force that causes the baby’s head to move quickly from a chin on chest position, all the way back.

Unfortunately, there is no definitive answer as to how hard is too hard; it is not known exactly how hard the shaking must be to cause harm. Never ever shake your baby, no matter how frustrated you feel.

Preventing Shaken Baby Syndrome is possible

Prevention programs have been shown to decrease the incidence of Shaken Baby Syndrome, and increase parental awareness of the dangers of shaking their baby. Carer education based prevention programs have shown promising results, with reductions in Shaken Baby Syndrome incidence of up to 50%.

Developed in Canada, the ‘Period of PURPLE Crying Program’ was created to educate parents about the reality of newborn crying and prevent parental frustration from spilling over into violence. The guidelines are widely recognised around the world, including here in Australia. The acronym PURPLE describes the features of an infant’s crying during this phase and assures parents that what they are experiencing is a normal and temporary stage in their child’s development.

Source: www.purplecrying.info

Closer to home, the Kids Health unit of the Children’s Hospital at Westmead has released a short animated video that provides suggestions and strategies for responding to a crying baby. It’s a great resource dealing with the challenges of managing a crying baby and provides safe strategies for responding. Arm yourself with this knowledge now so that you’re prepared for your baby’s next attempt to qualify for the Olympics in ‘Incessant Bouts of Crying for No Reason’.

Take a break, don’t shake

There’s little else that can make you feel as inadequate than when your crying baby can’t be calmed. You’re the mum, you should know what to do, right? I’ve been there myself, plenty of times. You may find yourself tempted to try anything to get the noise to stop — not to hurt your baby, but just to MAKE.IT.STOP!

Some of the things that worked for me in these moments were to remember that:

You must always treat your child gently. Nothing justifies shaking a child.
Working out what is causing a baby to cry can be a process of elimination. Get out your checklist of things – is s/he hungry, too cold/hot, have a dirty/wet nappy, overtired/overstimulated, need comfort. Try to resolve each one in turn.
Babies cry and may resist soothing, no matter what you try. It can be perfectly normal for babies to cry for several hours for no obvious reason.
Your baby will be ok to cry while you take a break and settle your nerves. If you feel like you’re reaching your limit, before you get angry or desperate, place your baby in a safe place and leave the room.
If people offer help, take them up on it.
Reach out to a friend or family member and ask for help.
Tag team it with your partner; take turns to prevent either of you reaching your limit.
Look after yourself. You’re not superwoman and no one expects you to be!
And lastly, the crying will stop. It’s a normal phase in a baby’s development and it won’t last forever.

Remember, if you are really struggling there is help available to you.

If you’re having trouble managing your emotions or the stress of parenthood, let someone know how you feel. You can see your GP for a referral to a counsellor or other mental health provider. If you need to speak to someone sooner, there are some great phone services available at no cost.

beyondblue on 1300 22 4636
PANDA (Perinatal Anxiety and Depression Australia) on 1300 726 306
Pregnancy, Birth & Baby helpline: 1800 882 436

What strategies have you found useful for dealing with an unsettled baby?

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