Babies cry. In fact, they start their life by crying. And till they learn to talk and even after that, crying is the most prominent mode of communication they use. For a parent or a babysitter, it can sometimes be frustrating, specially if it cries in the middle of the night or at times of great stress. We shush, we make funny faces and then usually "Rock-a-baby", shaking it so that it stops crying. We even manage to throw in a lullaby in between. However, the shaking action can be dangerous if not outright fatal- a very sad but true fact that many of us are unaware of.
Shaken Baby Syndrome (SBS) or Abusive Head Trauma, as it is called, is a severe injury that is caused by rapid, sudden motion of a baby's neck and head. The single biggest cause is vigorous shaking of the baby by a caregiver when it cries continuously. A single, unintended act can result in severe brain damage, lifelong disability, visual impairment (including blindness), motor impairment (including cerebral palsy) and in many cases, death. SBS accounts for the highest number among deaths caused by child abuse in the US and many other countries each year. Often, there are no external evidences of the trauma and internal damage can occur in the brain which are diagnosed only much later.
How it happens
A baby's neck muscles are not strong enough to support it's head. Shaking or rocking can cause the head to rotate around the neck uncontrollably. When the baby's head moves back and forth continuously, the blood vessels inside the brain could get ruptured. It could also lead to tearing of brain tissues and bruising of the brain when it rubs against the skull. The problem is compounded if after shaking, the head comes in forceful contact with a solid surface such as a wall, floor, mattress or pillow.
Most of the victims are under the age of one year since their muscles are hardly developed and most actions are involuntary or caused by others. However, it could also happen in older children. Children should not be subjected to any form of violent action at any time.
Prevention
Shaken Baby Syndrome is absolutely preventable. In most cases, culprits are new parents who haven't learnt to handle a baby or caregivers who are under stress. The baby's crying frustrates them and they shake the baby to quieten it. Unfortunately, in most cases, it works, and the baby stops crying. Not because the baby likes the shaking action, but because its brain has been damaged.
Awareness is the most practical way to prevent occurrence of SBS. Caregivers need to be informed of the probable consequences of their actions. Even gentle shaking needs to be avoided because if the baby continues crying, gentle shaking can rapidly accelerate into a more vigorous one and end up shaking the child's brain.
There are alternate ways of hushing the baby. Firstly, one needs to understand why the baby is crying. In most cases, its physical needs are probably not met. It might be hungry or thirsty, it may need a change of diaper or may be facing discomfort in some way (poking objects in the cot or probably even an ant or mosquito). If it doesn't cease crying, shush it, sing to it or take it out for a short ride. Diverting its attention by handing it a toy can also help quieten it as can giving it something to suck on. Whatever you must do, don't lift and shake it or rock the cradle hard.
Count to ten
This is what a Public Service Announcement broadcast on television in certain countries directed at parents and caregivers says. Patience is a life-saving virtue. Understand that a baby will cry and more often than not, its crying will not be compatible with your timings. Tell yourself to be patient, count to ten and then resolve its problem in whatever way you can. If it cries continuously for very long, call a paediatrician.
Best Regards
Prakash Nair
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