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SBS (shaken baby syndrome) preventionDisclaimer: This fact sheet is for educational use only. Please consult your doctor or other health professional to make sure this information is right for your child. Key points to remember
 Back to TopWhat is SBS (shaken baby syndrome)?SBS (shaken baby syndrome) is a combination of serious injuries that can occur when an infant or young toddler is violently shaken.
It is the single most preventable cause of serious head injury in babies under one year of age in New Zealand.
It may only take one or two hard shakes to seriously injure such a small child. This is because babies and toddlers have relatively big, heavy heads and weak neck muscles. When they are shaken the brain slams back and forth inside the skull, resulting in bleeding around the brain and damage to the brain itself. Some babies may even stop breathing, which can cause further brain damage.
In addition, the shaking can cause bleeding into the back of the eyes. Many babies who are shaken also have broken ribs because they are held forcibly around the chest and squeezed when they are shaken. They may also suffer other broken bones during the shaking.
Back to TopHow can SBS happen?SBS usually happens when a parent or other caregiver shakes a baby or toddler very hard because they are very frustrated with them. The number one reason given for shaking a baby is “I just wanted the baby to stop crying”. Forceful shaking may stop the baby crying, because it causes a head injury.
See the following for information and tips for when your baby is crying:
Back to TopWhat are the consequences of shaking a baby?The baby is likely to be significantly unwell from the time they were severely shaken. There may be vomiting, irritability, fits (seizures), drowsiness, and even coma. There is a range of severity in this condition, and some babies may be only mildly unwell. However, it will be clear to a parent / caregiver that their baby is not their usual self from the time that the shaking happened. They may be very fussy and go off their feeds, or vomit.
There are serious long-term consequences for babies that are severely shaken. There may be:
Overall, 15 - 35 percent of babies that are shaken die, and there is permanent brain and / or visual damage in 50 percent of survivors.
Back to TopHow can you prevent SBS?SBS happens when parents or caregivers get frustrated with their baby or toddler, often in the case of babies because they are crying.
Always remember:
It helps to have a plan of what you will do if your baby keeps crying and you become upset or even angry.
See the section below:
Back to TopWhat if my baby keeps crying?There is something called "the period of PURPLE crying" which refers to a time period when some babies begin crying more and may be hard to settle. This usually starts at about two weeks of age and peaks at eight weeks. It usually resolves by 12 weeks of age. The letters in PURPLE stand for the common parts of non-stop crying in infants:
P – peak pattern (crying peaks around two months of age, then decreases)
U – unpredictable (crying can come and go for no reason) R – resistant to soothing (baby may keep crying no matter what you do to try to soothe them)
P – pain-like look on baby's face
L – long bouts of crying (crying can go on for hours)
E – evening crying (baby cries more in the afternoon and evening)
Parents may feel guilty and angry if they can't soothe their baby. The period of PURPLE crying tells us that if a baby is not ill and parents have tried to soothe baby, it is alright if they cannot stop baby from crying. Some babies are going to cry no matter what. The good news is that the period of PURPLE crying will end!
Here are some tips to help you cope with a crying baby:
If you are worried that your baby is crying because they are unwell, see your GP (general practitioner) or after-hours medical centre.
If all of the above seem fine and your baby is still crying you could try:
If you have tried everything and your baby is still crying:
For more information and tips for when your baby is crying, see:
Back to TopWhat should you do if you think your baby has been shaken?Take your baby to your nearest hospital’s accident and emergency department straight away.
Dial 111 for urgent medical help if your baby is unconscious or having breathing trouble (see Emergencies - dialling 111 on this website).
Don’t let guilt or fear get in the way of your child’s health. If your baby has a serious head injury because they have been shaken, it will only get worse without treatment. Early medical attention may save your baby’s life and prevent serious long-term problems.
If your baby seems quite well but is fussy and / or vomiting, it is important that you tell the doctor that you know or suspect your baby has been shaken, so that they can give the proper treatment.
Back to TopWhat can you do if you think you might hurt your baby?Put your baby in a safe place and leave the room. Give yourself a break and seek help (see Where can you go to for help if you feel stressed?).
Back to TopWhere can you go to for help if you feel stressed?
 For more ideas on how to cope with stress, see Tips on stress (you can also download the brochure at right) – a SKIP (Strategies with kids / Information for parents) pamphlet – at the Ministry of Social Development website. The pamphlet gives some useful, brief information on trying to manage stress so that it doesn’t become overwhelming. The information is organised under the following headings:
Back to TopWhere to go for more information and supportOn this website
Parenting under fives, including coping with stress
 ADHB (Auckland District Health Board)ADHB has produced the following pamphlet:
Barnardos
Barnardos works within the community to provide a range of care, education, information and support services for children and their families. Services include family counselling and family support, a one-to-one service developed for families under stress. You can find contact details of an office near you by visiting the Barnardos website or looking under Barnardos in your phone book. National Office physical address: 85-87 Ghuznee Street, Wellington.
Postal address: PO Box 6434, Wellington Phone: 64 4 385 7560 Fax: 64 4 382 6700 Website: http://www.barnardos.org.nz/ CAB (Citizen’s Advice Bureau)
You can contact your local CAB for details of local crisis counselling services, as these differ from centre to centre. There is also a CAB Multi-lingual Information Service. Call free on 0800 FOR CAB (0800 367 222) Website: http://www.cab.org.nz/ Child, Youth and Family Services
Child, Youth and Family works with families to protect children and young people, promote the well-being of children, young people, their families and family groups, ensure that children in need are secure and cared for and help families maintain and strengthen their child-rearing role. Child, Youth and Family is the government agency that has legal powers to intervene to protect and help children who are being abused or neglected or who have problem behaviour. The Child, Youth and Family website provides access to a range of brochures which you can download. Child Matters (Educating to Prevent Child Abuse)
Child Matters is a registered charitable trust dedicated to preventing harm to children in New Zealand. Child Matters provides the following services, aimed at safeguarding children and helping in early detection and intervention when children are at risk or are being abused:
Training and professional development programmes are held throughout New Zealand.
Address: PO Box 679, Hamilton
Phone: 64 7 8383370 Fax: 64 7 8389950 Email: info@childmatters.org.nz Website: http://www.childmatters.org.nz/ Family Start
Family Start is a free home-based service to support parents and families so children have the best possible start in life. The service covers health and well-being, positive parenting and support for social issues for your family. You can be referred from six months before the birth of your child up to one year after. To find out if Family Start operates in your area, you can ask your Well Child provider, your GP (general practitioner) or your LMC (lead maternity carer). You can also call the Family Start national co-ordinator on 04 978 4239 for details of your nearest Family Start provider. Alternatively, see Family and Community Services for contact details for Family Start. PAFT (Parents as First Teachers)
PAFT is based on the philosophy that parents are their children's first and most important teachers. The aim of the PAFT programme is to help parents to participate more effectively in their children's early development and learning. PAFT provides free, practical support and guidance to families with young children. This support lasts from before birth to three years. Funding is available for a limited number of families only and enrolment criteria may apply. Contact Family and Community Services for more information or to find out if there is a programme near you. The PAFT National Centre is part of Family and Community Services at the Ministry of Social Development.
Website: http://www.familyservices.govt.nz/working-with-us/programmes-services/positive-parenting/paft/
Parentline
Parentline deals with children who have been sexually, physically or emotionally abused or who are at risk of abuse. Parentline acts as a child advocacy service:
Postal address: PO Box 11077, DX Mail: GX 33397, Hamilton
Phone: 64 7 839 4536 Fax: 64 7 839 4515 Email: parentline@parentline.org.nz
Website: http://www.parentline.org.nz/
Plunket
Plunket is New Zealand's leading provider of Well Child and family health services in New Zealand. It offers parenting education and support. Plunket Karitane Family Centres provide extra help and support on parenting matters such as breast feeding, sleeping, child behaviour, parent / family needs, and other child health concerns. Call the Family Centre in your area to find out what services they offer. For your local Plunket office or Plunket Karitane Family Centre, check the Plunket website or look under Plunket in your phone book. Plunket also offers a specialist early childhood health telephone help service. It is available to all families, whanau and caregivers 24 hours a day, seven days a week. Call PlunketLine free on 0800 933 922. Postal address: PO Box 5474, Wellington 6145
National office phone: 64 4 471 0177
National office fax: 64 4 471 0190
Email: plunket@plunket.org.nz
Website: http://www.plunket.org.nz/
Power to Protect (Ministry of Social Development)
This Ministry of Social Development website features the following message:
The website provides access to resources about preventing shaken baby syndrome.
Shine
Shine (previously known as Preventing Violence in the Home) provides a range of services (not all are national), including a comprehensive web site on family violence. Although the organisation is Auckland based, the information on the website is nationally relevant. The organisation provides a national helpline: 0508-DVHELP ( 0508 384357; 0508 384357 ). The helpline operates 7:30am -11:00pm every day.
Website: http://www.2shine.org.nz/
Telephone counselling lines
International websites
National Centre on Shaken Baby Syndrome, United States
A website designed to be helpful to parents and professionals looking for information, ideas and answers to questions about shaken baby syndrome. Website: http://www.dontshake.org/
Back to TopYour notesEndorsement
This fact sheet was endorsed by PSNZ - 17/09/2010
CopyrightFact sheets are subject to copyright. In the interests of information sharing they may be copied but acknowledgement must be given to PSNZ and Starship Foundation. © The Paediatric Society of New Zealand and Starship Foundation 2005 - 2012
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