Shaken baby syndrome

Shaken baby syndrome

Printer-friendly versionPrinter-friendly version

Key points to remember

  • it is never ever okay to shake a baby. Make sure that all the people who care for your baby know this
  • never leave your baby alone with someone that you know has an anger problem or violent temper
  • Power to protect - coping with a crying baby pamplet (Auckland District Health Board / Child Youth and Family)have a plan of what YOU will do if your baby keeps crying (see Crying - what to do) and you become upset or frustrated. There are things you can do and people who can help you (see Where can you go to for help if you feel stressed? below)
  • remember, crying is normal behaviour for babies. It is one of the few ways they have to communicate. Crying does not mean that they are being naughty

What 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 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.

The shaking can also 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.

How 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:

What 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:

  • permanent brain damage
  • paralysis (caused by damage to the spinal cord)
  • blindness
  • deafness
  • fits (seizures)
  • broken bones
  • delays of normal development
  • death

Overall, 15 - 35 percent of babies that are shaken die, and there is permanent brain and / or visual damage in 50 percent of survivors.

How 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 is normal for babies to cry. This is how they communicate with you
  • it's okay to walk away
  • never, ever shake a baby!
  • never leave your baby alone with someone who may lose control
  • share this message with everyone who is caring for your baby
  • if you think your baby may be injured, seek medical help at once

It helps to have a plan of what you will do if your baby keeps crying and you become upset or frustrated.

See the section below:

What 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 ends by 12 weeks of age. The letters in PURPLE stand for the common parts of non-stop crying in babies:

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:

  • try feeding your baby; if they don’t seem interested, they are not hungry
  • change your baby’s nappies if they are wet or dirty
  • make sure your baby is not too hot or too cold
  • try cuddling your baby – they may be lonely or need comforting
  • make sure there are no tight clothes on your baby that are hurting them somewhere
  • if your baby is showing tired signs, put them down somewhere safe to sleep; tired signs include yawning, rubbing the eyes, fist-sucking, as well as grumpiness

If you are worried that your baby is crying because they are unwell, see your doctor or after-hours medical centre.

If all of the above seem fine and your baby is still crying you could try:

  • swaddling your baby in a soft warm blanket, making sure their face is clear; babies love to feel secure and snug
  • singing or talking quietly to your baby, or playing some gentle music; babies like soothing noises
  • taking your baby for a walk in a front pack or stroller; you could also put your baby in their car seat and take them for a drive. Motion generally helps to calm a baby down, and it’s good for you too!
  • calling a friend or family member; maybe they could come over and give you a break

If you have tried everything and your baby is still crying:

  • put your baby in a safe place (such as their bassinet or cot) and leave the room for a while
  • take a break - you have done everything that you can and have met all of your baby’s needs
  • check on your baby every 10 - 15 minutes
  • remember, it is okay for babies to cry – it is normal and it won’t hurt them
  • please don't shake them!

For more information and tips for when your baby is crying, see:

What 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.

What 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?).

Where can you go to for help if you feel stressed?

  • a friend or family member
  • your GP (general practitioner)
  • your midwife if your baby is less than six weeks old
  • your local Plunket nurse or family centre (see Where to go for more information) or other Well Child provider (see Who provides Well Child / Tamariki Ora services?) 
  • telephone lines
    – Lifeline (phone 24 hours; 0800 543 354 or for callers in the Auckland area 64 9 522 2999)
    – national helpline run by Preventing Violence in the Home : 0508-DVHELP (0508 384 357). The helpline operates 7:30am -12 midnight weekdays and 9am - midnight weekends
    – Samaritans (only available in some areas; phone numbers in front few pages of your white pages phone book)
    – Youthline for young parents (phone 0800 376 633)
    – Healthline on 0800 611 116
    – PlunketLine 0800 933 922 
  • Family Start (see Where to go for more information)
  • Child Youth and Family Services - 0508 FAMILY (0508 326 459) (see Where to go for more information)
Tips on stressFor 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:
  • things that could help
  • things that won’t help
  • managing your day
  • setting some goals
  • what to do if you’re worried

Where to go for more information and support

On this website
Crying - what to do
Preventing abuse
What if I'm worried about a child?
When abuse has occurred
Family violence
Child protection (more information, resources, support)
Parenting under fives

Barnardos www.barnardos.org.nz
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
 
CAB (Citizen’s Advice Bureau) www.cab.org.nz
You can contact your local CAB  for details of local crisis counselling services, as these differ from centre to centre.
See the CAB website for:
Call free on 0800 FOR CAB (0800 367 222).
 
Child, Youth and Family Services www.cyf.govt.nz
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. See the Child, Youth and Family website for:
Phone: 64 9 912 3820 or 0508 FAMILY (326 459)
Fax: 64 9 914 1211
 
Child Matters (Educating to Prevent Child Abuse) www.childmatters.org.nz
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 programmes (NZQA approved)
  • seminars
  • workshops
  • advice, resources and handbooks
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
 
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 website for more information about Family Start, and for contact details for Family Start. 
 
Family & Community Services 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 by email or telephone for more information about joining PAFT. The PAFT National Centre is part of Family and Community Services at the Ministry of Social Development.
 
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:
  • to bring to light cases of child abuse or neglect, through public education and raising public awareness of the effect of abusive parents
  • to explore fully the factors giving rise to abuse or neglect of children by providing documentation and undertaking research
  • to consult with and refer where appropriate to organisations both voluntary and statutory connected with the welfare of children
  • to provide immediate and ongoing support to families where child abuse or neglect has occurred, to achieve rehabilitation of the abusing family where possible and reconciliation of the child with his or her family
  • ensure that a Maori perspective is encouraged and maintained
Postal address: PO Box 11077, DX Mail: GX 33397, Hamilton
Phone: 64 7 839 4536
Fax: 64 7 839 4515
 
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. See the Plunket website for:
Power to protect - coping with a crying baby pamplet (Auckland District Health Board / Child Youth and Family)Power to Protect (Ministry of Social Development) www.powertoprotect.net.nz
See this Ministry of Social Development website for the pamphlet
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.
 
Telephone advice - Healthline and PlunketLine
  • ring PlunketLine on 0800 933 922 if you have child health and parenting questions or queries. For example, if you have questions about such issues as parenting, crying, sleeping, your child's growth, development, behaviour, immunisation, breastfeeding, nutrition, oral health, safety or want to know more about the Well Child / Tamariki Ora programme
  • call Healthline on 0800 611 116 if you need advice about a child of any age who is unwell or hurt, or has any symptoms of sickness. Healthline provides a full range of telephone triage and health advice for children (and adults)
  • both services are available 24 hours and are free to callers throughout New Zealand, including from a mobile phone

Telephone counselling lines 

  • Samaritans (only available in some areas; phone numbers in front few pages of your white pages phone book)
  • national helpline run by Preventing Violence in the Home : 0508-DVHELP (0508 384 357). The helpline operates 7:30am -12 midnight weekdays and 9am - midnight weekends
  • Lifeline (phone 24 hours; 0800 543 354 or for callers in the Auckland area 64 9 522 2999)
  • Youthline for young parents (phone 0800 376 633)
International websites
 
National Centre on Shaken Baby Syndrome, United States www.dontshake.org
A website designed to be helpful to parents and professionals looking for information, ideas and answers to questions about shaken baby syndrome.
 
Attached Files: 
Coping with a crying baby (Child, Youth and Family and Auckland District Health Board brochure)
Content endorsed by the Paediatric Society of New Zealand 25 May 2012
© Paediatric Society of New Zealand and Starship Foundation 2005 – 2013
Printed on 25 May 2013. Content is regularly updated so please refer to www.kidshealth.org.nz for the most up-to-date version