Countless studies have shown that the number one reason an adult shakes a baby is out of sheer frustration, when the baby just won’t stop screaming. People reading this article are probably wondering how on earth could anyone harm a tiny baby. The bottom line is that in 99% of cases, the adult never meant to shake the baby. It is a moment of absolute desperation with devastating consequences. This is known as shaken baby syndrome.
In a previous article I wrote about ‘Why babies cry and how to soothe them’, I covered what is normal and when to worry. The article predominantly focused on the baby and the possible causes of excessive crying. This included medical reasons like reflux, urinary tract infections, milk intolerance and other illnesses. I also gave advice on how to calm a screaming baby if medical reasons for the crying had been excluded.
Where this leads me now is to the parent or caregiver. A baby that cries incessantly, for no apparent reason and cannot be soothed has the ability to stress an adult out to such an extent that in a split second the adult reacts and shakes the baby.
What happens when a baby is shaken?
We all know that a tiny baby has weak neck muscles and it takes time for a baby to be able to control its head. This means that a baby that is shaken will have no control over its head and the head will move suddenly forward onto the chest and then back, often touching the upper part of the back. It takes a single shake for this to occur and in this time, the brain hits the front and then the back of the skull. This causes the brain to bleed, bruise and swell. At the same time, the retina of the eye can tear and also bleed.
Signs and symptoms that a baby may have been shaken
It is a terrifying thought that over 80% of babies that are shaken suffer very severe brain injuries; 30% of babies die while others are left with lifelong disabilities like cerebral palsy, seizures, blindness and, in milder cases, severe learning difficulties. Since the injuries are internal, it may not be immediately obvious that the baby has been shaken.
Babies who have been shaken may display the following signs:
- Breathing problems
- Extreme irritability
- Excessive sleepiness
- Pale or bluish skin
- Difficulty moving
How can shaken baby syndrome be avoided?
- Probably the single most important factor to avoid shaken baby syndrome is to understand that babies do cry. They can cry a lot and for no apparent reason. If a medical practitioner has excluded illnesses then the crying may just be a normal part of development.
- This type of crying has been given a name and description. It is known as the “Period of Purple Crying”. What I believe parents and caregivers need to understand is that the baby will cry regardless of what you do and it is NOT your fault! Let me expand using a diagram that I find useful. (http://purplecrying.info/what-is-the-period-of-purple-crying.php)
- If the parent or caregiver feels out of control or overly stressed by the crying, then put the baby into their crib and leave for 10 minutes or so. The baby will be safe and probably still crying when you return, but you would have had a moment to calm down.
- Don’t be afraid to ask for help. Many grandparents went through the same experience of crying. Granny, Grandpa, Aunty or a friend can easily step in for half an hour or so. The crying won’t be pleasant for them but it will give you a break.
- If you don’t have anyone to call, then strap your baby to you and go for a walk. The change of scenery will help clear your mind and chances are your baby will eventually stop crying.
Shaken baby syndrome is the most common form of child abuse seen in children under one year of age. Those charged with this kind of abuse are more often than not normal people who in a moment of absolute frustration shook a baby by the shoulders, arms or legs. Five seconds is all it takes to inflict a major brain injury on an infant.
“Shaken baby syndrome is the most common form of child abuse seen in children under one year of age.”
It is so difficult to imagine unless you have personally experienced an infant that just doesn’t stop crying. As a paediatrician, I do my utmost to exclude a medical cause for the excessive crying but there are often times a baby is absolutely well. It just cries a lot. This is frustrating for the practitioner trying to help and for the parents who keep going back to the doctor looking for answers.
Under these circumstances, it is vital that parents and caregivers alike are educated on “The Purple Phase of Crying” and understand that they need to surround themselves with support in the first four months of a baby’s life. The important thing to remember is that the excessive crying is a phase and by the time the baby is around four months, the excessive crying will stop.
I have read some heart-wrenching stories of parents who really suffered through this stage. If you are one of them, ask for help, go for a walk, read about the condition BUT never allow yourself to be pushed to the point of shaking your baby.
This article was written for BabyYumYum by our partner paediatrician, Dr Maraschin.