Shaken baby syndrome: What are the signs and symptoms?

Shaken baby syndrome is a group of signs and symptoms caused by severe brain injury due to violent shaking of an infant. Since an infant's neck muscles aren't strong enough to limit motion of the head, shaking causes the baby's brain to bounce back and forth within the skull. This may result in bruising, swelling and bleeding within the brain, which can lead to permanent, severe brain damage or even death. If you know or suspect an infant has been shaken, seek emergency medical care for the child.

Signs and symptoms of shaken baby syndrome include:

• Irritability
• Lethargy or excessive sleepiness
• Decreased alertness
• Pale or bluish skin
• Vomiting
• Poor sucking and swallowing
• Inability to lift head, focus eyes or track movement
• Loss of consciousness
• Seizures
• Not breathing (apnea) or difficulty breathing

Usually, there are no external physical signs of trauma, such as bruising, bleeding or swelling. A doctor may make a diagnosis of shaken baby syndrome based on:

• Bleeding in the back of the eye (retinal hemorrhage) or retinal detachment
• Skull fracture
• Swelling of the brain
• Bleeding on the surface of the brain (subdural hematoma)
• The absence of external injuries in a child with severe brain injury
• Fractured rib, arm or leg bones
• Bruises on the head, neck or chest

The majority of cases of shaken baby syndrome occur in children younger than 12 months. This condition is usually the result of child abuse. Shaken baby syndrome doesn't result from gentle bouncing or play.

A shaken baby requires emergency medical attention. Don't allow the infant to "sleep it off," during which time brain damage may progress. Also, don't wait for serious signs and symptoms to appear before seeking help.