Shaken baby syndrome: Difference between revisions

Fractures of the [[vertebrae]], [[long bones]], and [[ribs]] may also be associated with SBS.<ref>{{cite journal | vauthors = Kempe CH, Silverman FN, Steele BF, Droegemueller W, Silver HK | title = The battered-child syndrome | journal = JAMA | volume = 181 | pages = 17–24 | date = July 1962 | pmid = 14455086 | doi = 10.1001/jama.1962.03050270019004 | citeseerx = 10.1.1.589.5168 }}</ref> Dr.Infants may display irritability, [[Johnfailure to Caffeythrive]], reportedalterations in 1972eating thatpatterns, metaphyseal[[lethargy]], avulsions[[vomiting]], (small[[seizure]]s, fragmentsbulging ofor bone torn off where the periosteum covering the bone and thetense [[cortical bonefontanelle]]s are(the tightlysoft bound together) and "bonesspots on both the proximal and distal sides of a singlebaby's joint are affectedhead), especiallyincreased atsize the knee".<ref name="Caffey J 1972 161–9">{{cite journal |vauthors=Caffey J |date=August 1972 |title=Onof the theoryhead, andaltered practice of shaking infants. Its potential residual effects of permanent brain damagebreathing, and mentaldilated retardation |journal=American Journal of Diseases of Children |volume=124 |issue=2 |pages=161–169 |doi=10[[pupil]]s.1001/archpedi.1972.02110140011001 |pmid=4559532}}</ref>

In 1971, [[Norman Guthkelch]] proposed<ref>{{cite journal |vauthors=Guthkelch AN |date=May 1971 |title=Infantile subdural haematoma and its relationship to whiplash injuries |journal=British Medical Journal |volume=2 |issue=5759 |pages=430–431 |doi=10.1136/bmj.2.5759.430 |pmc=1796151 |pmid=5576003}}</ref> that [[whiplash injury]] caused subdural bleeding in infants by tearing the veins in the subdural space.<ref>{{cite journal |vauthors=David TJ |date=November 1999 |title=Shaken baby (shaken impact) syndrome: non-accidental head injury in infancy |journal=Journal of the Royal Society of Medicine |volume=92 |issue=11 |pages=556–561 |doi=10.1177/014107689909201105 |pmc=1297429 |pmid=10703491}}</ref><ref>{{cite web |title=Integrity in Science: The Case of Dr Norman Guthkelch, 'Shaken Baby Syndrome' and Miscarriages of Justice |url=http://www.argumentcritique.com/uploads/1/0/3/1/10317653/guthkelch_lw.pdf |archive-url=https://web.archive.org/web/20150309043634/http://www.argumentcritique.com/uploads/1/0/3/1/10317653/guthkelch_lw.pdf |archive-date=9 March 2015 |website=Argument & Critique |vauthors=Wrennall L}}</ref> The term "whiplash shaken infant syndrome" was introduced by Dr. [[John Caffey]], a pediatric radiologist, in 1973,<ref>{{cite journal |vauthors=Caffey J |date=October 1974 |title=The whiplash shaken infant syndrome: manual shaking by the extremities with whiplash-induced intracranial and intraocular bleedings, linked with residual permanent brain damage and mental retardation |url=http://pediatrics.aappublications.org/cgi/content/abstract/54/4/396 |url-status=live |journal=Pediatrics |volume=54 |issue=4 |pages=396–403 |doi=10.1542/peds.54.4.396 |pmid=4416579 |s2cid=36294809 |archive-url=https://web.archive.org/web/20100313182616/http://pediatrics.aappublications.org/cgi/content/abstract/54/4/396 |archive-date=13 March 2010 |access-date=30 April 2011}}</ref> describing a set of symptoms found with little or no external evidence of head trauma, including retinal bleeds and intracranial bleeds with subdural or [[Subarachnoid hemorrhage|subarachnoid bleeding]] or both.<ref name="Caffey J 1972 161–9">{{cite journal |vauthors=Caffey J |date=August 1972 |title=On the theory and practice of shaking infants. Its potential residual effects of permanent brain damage and mental retardation |journal=American Journal of Diseases of Children |volume=124 |issue=2 |pages=161–169 |doi=10.1001/archpedi.1972.02110140011001 |pmid=4559532}}</ref> Development of [[computed tomography]] and [[magnetic resonance imaging]] techniques in the 1970s and 1980s advanced the ability to diagnose the syndrome.<ref name="pmid11433079" />

Common risk factors for Shakenshaken Babybaby Syndromesyndrome include perceived excessive crying, [[behavioral health]] problems, [[domestic violence]] history, frustration intolerance, lack of childcare experience, young infant age, young maternal age, [[multiple birthsbirth]]s, having a male infant, full-time working, [[postpartum depression]], single parent families and economic adversity.<ref name="ReferenceA">{{Cite journal |date=2016-01-05 |title=Self-Reported Prevalence and Risk Factors for Shaking and Smothering Among Mothers of 4-Month-Old Infants in Japan |journal=Journal of Epidemiology |volume=26 |issue=1 |pages=4–13 |doi=10.2188/jea.JE20140216 |issn=0917-5040 |pmc=4690735 |pmid=26639749 | vauthors = Fujiwara T, Yamaoka Y, Morisaki N }}</ref><ref name=":11">{{Citation |last1=Joyce |first1=Tina |title=Pediatric Abusive Head Trauma |date=2024 |work=StatPearls |url=http://www.ncbi.nlm.nih.gov/books/NBK499836/ |access-date=2024-08-01 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=29763011 |last2=Gossman |first2=William |last3=Huecker |first3=Martin R.}}</ref> The perpetrators of acute head trauma typically involve the father, stepfather, mother's boyfriend, female babysitter and the mother.<ref name=":11" /> The age group from child birth to the age of 4 are at greater risk of SBS due to multiple factors, including disproportionate anatomy, lack of or inability to communicate needs, and inability to protect self from a larger adult.<ref name=cs>{{Cite journal |last=Walls |first=Carrie |date=September 2006 |title=Shaken Baby Syndrome Education: A Role for Nurse Practitioners Working With Families of Small Children |url=https://doi.org/10.1016/j.pedhc.2006.02.002 |journal=Journal of Pediatric Health Care |volume=20 |issue=5 |pages=304–310 |doi=10.1016/j.pedhc.2006.02.002 |pmid=16962435 |issn=0891-5245}}</ref>

Episodes of [[baby colic|colic]] are greatest at 6 to 8 weeks of age, and studies have shown a peak in SBS incidence during this time as parents may perceive these episodes as excessive crying.<ref name="Joyce_Gossman_Huecker_2023" /> Caregivers that are at risk for becoming abusive often have unrealistic expectations of the child and may display "role reversal", expecting the child to fulfill the needs of the caregiver.<ref name="pmid11433079" /> [[Substance abuse]] and emotional stress, resulting for example from low [[socioeconomic status]] or family instability, are other risk factors for aggression and impulsiveness in caregivers.<ref name="pmid11433079" /><ref name=":6">{{cite journal | vauthors = Karibe H, Kameyama M, Hayashi T, Narisawa A, Tominaga T | title = Acute Subdural Hematoma in Infants with Abusive Head Trauma: A Literature Review | journal = Neurologia Medico-Chirurgica | volume = 56 | issue = 5 | pages = 264–273 | date = May 2016 | pmid = 26960448 | pmc = 4870181 | doi = 10.2176/nmc.ra.2015-0308 }}</ref> Caregivers of any gender can cause SBS, but cases of SBS have been reported to be more common amongst younger parents.<ref name="pmid11433079" /><ref name=":6" /> Studies have shown increased prevalence of SBS among parents 34 years old or younger, especially 24 years old or younger.<ref name="ReferenceA"/> Although it had been previously speculated that SBS was an isolated event, evidence of prior child abuse is a common finding.<ref name="pmid11433079" /> In an estimated 33–40% of cases, evidence of prior head injuries, such as old intracranial bleeds, is present.<ref name="pmid11433079" />

At the community level, risk factors for Shakenshaken Babybaby Syndromesyndrome include social isolation, lack of recreational facilities, lack of external support from family or governmental agencies, unsafe neighborhoods and societal factors such as poverty.<ref name=":11" /><ref name=cs/>

Shaken Baby Syndrome, also called as Shaken Impact Syndrome, is a severe form of child abuse. It occurs when parents or caregivers shakes a baby.<ref>{{Cite web |title=Shaken Baby Syndrome |url=https://www.aans.org/patients/conditions-treatments/shaken-baby-syndrome/ |access-date=2024-07-29 |website=AANS |language=en-US}}</ref> There is a strong association between crying and SBS, where studies indicate 1-6% of parents have shaken their babies to stop crying {{Citation needed|date=September 2024}}. Furthermore, the caregiver's worries and views on crying are more predictive of shaking than the objective amount of crying.<ref>{{Cite journal |last=Altimier |first=Leslie |date=January 2008 |title=Shaken Baby Syndrome |url=https://journals.lww.com/00005237-200801000-00014 |journal=Journal of Perinatal & Neonatal Nursing |language=en |volume=22 |issue=1 |pages=68–76 |doi=10.1097/01.JPN.0000311877.32614.69 |pmid=18287904 |issn=0893-2190}}</ref> Evidence indicates early crying pattern as the common trigger for SBS, and it results from a failure in what is usually a normal interaction between infants and caregivers.<ref>{{Cite journal |last=Barr |first=Ronald G. |date=2012-10-16 |title=Preventing abusive head trauma resulting from a failure of normal interaction between infants and their caregivers |journal=Proceedings of the National Academy of Sciences of the United States of America |volume=109 Suppl 2 |issue=Suppl 2 |pages=17294–17301 |doi=10.1073/pnas.1121267109 |doi-access=free |issn=1091-6490 |pmc=3477395 |pmid=23045677|bibcode=2012PNAS..10917294B }}</ref>