Shaken baby syndrome (SBS) is a traumatic shock related to violent shaking in infants. Consequences, causes, symptoms… We take stock on the occasion of Shaken Baby Syndrome Day, this Tuesday, April 5, 2022.
[Mise à jour du 5 avril à 15h16]. The National Shaken Baby Syndrome Day is this Tuesday, April 5, 2022. The opportunity to come back to the symptoms and the consequences for the infant, and to prevent the risks by raising awareness among young parents.
What is Shaken Baby Syndrome?
the shaken baby syndrome is also called also head trauma inflicted by shaking (TCIS). This traumatic shock related to violent tremors for the child (with or without impact), can lead to irreversible damage, even death. To inform parents and health professionals, the High Authority for Health (HAS) has adapted its recommendations on the diagnosis of shaken baby syndrome in order to allow everyone to react in the event of child abuse.
“Stop Shaken Baby”: a campaign to raise awareness among parents
Each year, several hundred children are victims of shaken baby syndrome. “This abuse, perpetrated voluntarily by adults, sometimes in denial of the seriousness of their act, represents the most serious form of head trauma in children” specifies the government, which launched on January 17 a national shaken baby syndrome awareness campaignwho is at the origin of serious neurological sequelae which are manifested by intellectual, visual or motor deficiencies, as well as behavioral, speech or attention disorders. A film intended to mark the spirits. The message ? Shaking a baby is an abuse that can be fatal. Through the baby monitor, we hear a baby crying in his father’s arms, but he seems exhausted and doesn’t know what to do to silence him. We then understand that he shook his newborn when we can no longer distinguish the cries of the baby.
https://www.youtube.com/watch?v=vN6St7PVfUs
More and more shaken babies in France: what are the figures?
In France, one baby out of ten, victim of shaking, dies, the others will suffer the consequences all their life. In 2021, the pediatric neurosurgery department at the Necker hospital in Paris warned of theworrying increase in the number of shaken babies since the first quarter of 2021. “Between January and June 2021, the incidence doubled. From December 2020, we have seen an upsurge in arrivals of infants with subdural hematomas. While generally, we welcome between 18 and 25 per year, in the first quarter alone, 25 were admitted“says to the newspaper La Croix the professor of neurosurgery Thomas Blauwblomme. As for the severity of the injuries, it is just as worrying:”mortality has increased from less than 10% to 30% and we are seeing more associated lesions”.
Shaken baby: what are the risks?
Those are the excessive baby crying, which most often cause parents, or anyone else who cares for them, to shake them. Hardly supporting not knowing how to calm them down, they lose patience and end up mistreating them. But what they don’t always know is that this act sometimes has irreparable consequences for the baby: 10% to 40% of them die as a result of a head trauma and the majority of the others retain severe, lifelong neurological sequelae. the shaken baby syndrome would concern in the majority of cases, children under 6 months, and particularly boys less than a month old. At this age, the infant’s brain is not fully developed, so it does not fill the cranial box. Also, during violent shaking, it can crash against the walls and cause a ruptured blood vessels. These brain damage can therefore occur even if his skull receives no shock. In addition, the fact that the head is proportionally heavier than that of an adult and that the muscles of the neck do not keep the baby’s head straight also promote brain damage.
What are the symptoms of shaken baby syndrome?
Infants with baby syndrome shaken have unusual behavior, characterized by one or more symptoms : unusual drowsiness, consciousness disorders or extreme irritability; from vomiting for no apparent reason; a loss of the usual smiles or babbling; a tendency not to stare; seizures; difficulty breathing or pauses in breathing. Faced with these signs, it is essential to contact the medical emergency services as soon as possible. Early diagnosis and care are essential to reduce neurological sequelae if they exist.
Neurological symptoms
- loss of consciousness, seizures, paralysis…
- changes in tone (axial hypotonia);
- poorer contact (child responding poorly to stimuli, no longer smiling);
- decrease in child’s skills;
- macrocrania with a break at the top of the curve (importance of the health record);
- bulge of the fontanel.
Less specific symptoms
- vomiting. pallor,
- unexplained change in behavior. of the baby: sudden fatigue or drowsiness that may *resemble the manifestations caused by a virus.
- faintness.
- respiratory arrest. or cardiac arrest.
- loss of vision.
Health professionals need to be made aware in order to constitute a relay with the parents and in particular with the young parents, as soon as they leave the maternity ward. According to the HAS, it is essential to inform them about infant crying, on the possibility of being exasperated by it and on the sometimes irreparable consequences of the shaking. She also returns to the need to advise parents on the right attitudes to adopt dealing with prolonged crying: put the baby on his back in his bed and leave the room. No need to feel guilty: it’s better to take care of yourself, it’s also a way to protect the baby. Do not violently shake a young child remains the essential attitude to know. Parents must learn to avoid getting upset and shaking their child when he cries.
Shaken baby syndrome and child abuse
The High Authority for Health has updated his memo card devoted to abused children and those at risk. “The difficulty and complexity of the situations, as well as the strong feeling of isolation of the health professional explain the need to provide up-to-date, clear and precise information to help them identify violence and to support them in the conduct to hold to protect the child“, specifies the press release. Beyond the signs of abuse undeniable such as broken bones, burns or bruises… health professionals will have to wonder more about less obvious signs such as a behaviour change of the child or the attitude of the parents.
In order to help professionals Better identify shaken baby syndrome and to raise awareness among the general public, the High Authority for Health has updated its recommendations, in collaboration with the French Society of Physical Medicine and Rehabilitation (SOFMER). The diagnostic criteria have been refined, taking into account in particular “the causal mechanism and the dating of the lesions“, but also the version reported by the accompanying adult. In addition, the skeletal X-rays to be taken have been listed, as have the MRI modalities. If a case of shaken baby syndrome is suspectedthe assessment to be carried out was specified, “in particular the exhaustive list of the necessary and sufficient elements of the haemostasis assessment“, specifies the HAS, which recalls that in case of doubt, “the child must benefit from hospitalization in pediatric intensive care, with neurosurgical opinion”.
As for health professionals, they must imperatively file a report with the public prosecutor in order to protect the child, and seek the advice of a colleague. “When SBS is suspected, an initial meeting of at least two doctors should take place without delay. A first report will be sent which can then be completed by a psycho-social assessment“, explains the HAS.
Flying… Watch out for dangerous games!
Parents must be careful not to play with their baby by making him move in all directions, or by making rotational movements, such as “doing the plane”, or even throwing him at arm’s length to catch him immediately.