SHAKEN BABY SYNDROME
By David Mallory, M.D.
Cathy and Steve Sanders remember their eight week old son,
Ryan, as a happy, active baby who was starting to smile at
his relatives. But one day, Ryan's development was abruptly
halted. On that day, a baby sitter, fed up with Ryan's
crying, grabbed him around the chest and shook him
vigorously, permanently damaging his brain and eyes. Now at
age two, Ryan suffers from cerebral palsy, mental
retardation, and blindness.
"His brain is not even on the charts anymore. As far as I am
concerned, what happened was murder," said Steve Sanders.
Ryan is a victim of what is called "shaken baby syndrome,"
or SBS. There are no exact statistics, but researchers
estimate each year between 800 and 1,200 children nationwide
are shaken so severely they require an emergency visit to a
hospital. Probably many more suffer milder symptoms and are
never treated. Twenty-five percent of shaken baby syndrome
victims die. The rest may have mental retardation, cerebral
palsy, and blindness.
The head of an infant or young child is disproportionately
larger and heavier than the rest of his or her body, but the
neck muscles are weak and undeveloped. Severe shaking of a
child age five or under, but especially in the first year of
life, causes the brain to smash or whiplash back and forth
against the skull. It is estimated that the force on a
shaken baby's brain is 30 times the force of gravity.
Fighter pilots black out at less than one-third of that
Bleeding in shaken baby syndrome (SBS) occurs not only in
and around the brain, but in the eyes as well, especially in
the retina that lines the inside of the eye and is the
actual "seeing" part of the eye. These hemorrhages occur in
up to 80 percent of shaken babies and in 70-100 percent of
children dying of SBS. It has also been shown that the
severity of the retinal hemorrhages can be a reliable
predictor of the degree of brain damage. Retinal hemorrhages
may even come before any brain injury can be detected on C-T
scan or MRI imaging. A child with convulsions and lethargy
may have as the only objective finding of shaken baby
syndrome hemorrhages in the retinas of the eyes.
In almost all cases, the person shaking the baby is trying
to get him or her to stop crying. Many parents who would
never consider striking their child, may resort to shaking
as a less violent approach. Five studies conducted between
1982 and 1990 showed that 25-50 percent of teenagers and
adults did not know that shaking a baby is dangerous. The
anguished cry of the father who said "I just wanted the baby
to stop crying. I only shook him for a few seconds, but
he'll be blind for a lifetime!" is not easily forgotten.
Shaking a baby is a very, very violent act!
David Mallory, M.D. is a cataract, intraocular lens and
laser surgery specialist in practice at the Southwest Eye