Shaken baby syndrome, or SBS, is a form of child abuse. It occurs when an abuser, generally an adult, violently shakes an infant or small child. The shaking motion creates a whiplash-esque motion that causes severe acceleration-deceleration injuries.
This type of injury, or abuse, is thought to affect between 1,200 and 1,600 children every year in the United States alone. The injury type is not restricted to the United States. All countries have the problem to some degree. One remarkable feature of shaken baby syndrome is that there is, typically, no external evidence of trauma. When a baby is shaken and strikes a hard object, this is called shaken impact syndrome, in many cases.
Shaken baby syndrome, as a concept, was originally described in the early 1970s. The description was based on a theory and a wide variety of circumstances and was posited by Drs. John Caffey and Norman Guthkelch. Dr. Caffey was a radiologist while Dr. Guthkelch was a neurosurgeon.
While it may sound minor, shaken baby syndrome is a major cause of mortality in infants. When it is not fatal, it can produce lifelong disabilities due to neurological damage. It is estimated that up to 50% of all deaths related to child abuse are due to shaken baby syndrome. Between one fifth and one quarter of all infant victims of shaken baby syndrome die due to their injuries.
When the baby does not die, the consequences are serious as well. They include visual impairment (blindness), motor impairment (cerebral palsy), and cognitive impairments.
Small children up to the age of three are particularly vulnerable to brain damage due to being shaken. This is due to a variety of anatomical factors. For starters, babies' heads are larger and make up a larger proportion of their body weight than adults' heads. In addition, a baby's neck muscles are weak and cannot help prevent violent motions.
Another problem is that infants' heads do not have myelin sheaths. Myelin sheaths are part of the brain's structure but are not developed completely until adolescence. As neurons gain myelin during development, the water content of the brain is reduced.
As a consequence, babies' brains have a higher percentage of brain water than adults. Because of the high water content, babies' brains are softer and more susceptible to acceleration-deceleration injuries as well as diffuse axonal injuries.
In shaken baby syndrome, rotation injuries are especially damaging and particularly likely to occur in shaking trauma. The types of injuries caused by shaking injuries are generally not caused by falls or impacts due to normal play. Those injuries are typically due to linear forces.
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