4What is Shaken Baby Syndrome? Violent Whiplash InjuryIntercranial BleedingUnconsciousnessInflicted, not accidentalResult of violently shaking a baby or childCauses severe disabilities or death due to brain injury
5Ages of SBS Victims Few days old --------five years Average age of six to eight months
6Inflicted, Not Accidental Child is violently shaken by caretakernot “jiggling” or gently playingany objective observer would say that the child will definitely be injuredchild shaken in rage, anger, and frustration
7Clinical Findings Associated with SBS Subdural hematomaRetinal hemorrhagesCerebral edemaDiffuse axonal injurySkull fractureSubarachnoid hemorrhages“Black brain” on CT or MRI - indicating severe ischemia, characteristic of a severe shake
8Clinical Signs of SBS*Subdural Hematoma. Accumulation of blood or blood clot beneath the dura. The dura is a fibrous membrane that surrounds the brain and attaches to the skull.Retinal Hemorrhages. Bleeding in the back of the eyeball.Cerebral Edema. Swelling of the brain. This causes pressure on various areas of the brain, some of which control breathing, heartbeat, etc.
9More Clinical Signs of SBS Diffuse Axonal Injury. Shearing of nerve fibers in white matter of the brain that destroys brain tissue.Skull Fracture.Subarachnoid Hemorrhage. Bleeding under the arachnoid membrane, a membrane attached to the innermost layer of the tissues surrounding the brain. This causes pressure on and injury to the brain.
10More Clinical Signs of SBS “Black Brain”. Wasting away of the brain due to lack of blood supply, seen on CT scan or MRI
11SBS Triad of Injuries Retinal Hemorrhage Subdural Hematoma Cerebral EdemaThe presence of this combination is characteristic of SBS. Other causes for this particular combination are remote.
12Who Are The Perpetrators of SBS Male caretakersBabysittersParents under severe stressParents who have psychiatric problems
13How Would You Know If Your Child Has Been Shaken?
14Warning Signs Unable to turn head Body pulls to one side Difficulty in breathingSeizuresLethargic, hard to rouseDilated or pin-point pupilsEyes don’t respond to lightBlood pooling in eyes
15Critical Advice If your child has any of these symptoms: Get medical attention immediatelyBe prepared to provide any helpful information to medical staff
16What Are the Effects of Shaking? Irreversible brain damageBlindnessLearning disabilitiesMental retardationSeizuresDeath
17How Does SBS Occur? Caretaker: Child: Is alone with child Frustrated by child’s cryingSees child’s crying as deliberateSees child’s crying as defianceChild:Crying is the only way the baby can communicateCannot protect self against violent assault
18Use Common SenseDon’t let anyone take care of a fussy baby by themselves, if:they have a hot temperthey are afraid of losing self-controlthey can’t pay full attention to the babythey don’t know how to handle a baby who is difficult to comfortthey don’t know how to handle a child who is demanding, crabby or annoyingthey think that babies 0-18 months “do things on purpose to make you angry”
19Caretakers Need to Stay In Top Condition Get Enough SleepStay SoberStay Healthy
21What To Check Is the baby sick? Is the baby hungry? Does the baby need to be burped?Does the baby need to be changed?
22How To Soothe A Crying Baby Rock the babyWalk with the babySwaddle the babyPlay some musicRub the baby’s backGive the baby a pacifierRead to the babyLeave a soft light on in the baby’s roomTake the baby for a ride in the car
23If That Doesn’t Work… Don’t Go It Alone! Get Some Help!
24How to Get Help Get someone to keep you company. Telephone a friend, ask for tips on how to handle the situation.Keep the number of a hot-line handy for support and guidance.
25Regarding Baby Sitters… It is the Parent’s Responsibility to: Instruct the babysitter every time that they are not to shake the baby, no matter what happens.Be sure your babysitters know how to reach you.Be prepared to come home immediately if your sitter can’t handle the job.
26When All Else Fails Let the baby cry. Put the baby down in a safe place. Check on the baby at intervals.Give yourself a break--find a quiet place for yourself.