Committee 4

Shaken Baby Syndrome: Inflicted Cerebral Trauma

Citation:

Committee on Child Abuse & Neglect: Shaken baby syndrome: inflicted cerebral trauma. Pediatrics 92(6):872-875, December 1993.

Notes:

"The act of shaking/slamming is so violent that competent individuals observing the shaking would recognize it as dangerous." (p. 873)
Parents with psychiatric difficulties or under stress may be more prone to be impulsive and aggressive.
It some cases it may not be clear that there was intent to harm. In other cases, the careless disregard for safety and force required suggests intent to seriously injure if not kill the child.
Infants may have a history of poor feeding, vomiting, lethargy, and/or irritablity occurring intermittently for days or weeks before medical care is sought.
One caretaker may be aware of the true source of injury while others are not.
Differential diagnoses: meningitis, anemia, clotting dysfunction, vitamin K deficiency, liver injury.
Thorough investigation should be done immediately, before caretakers can compare stories.
Parents should be asked about their stress level.