Shaken baby syndrome is a serious brain injury that results from forcefully shaking an infant or a toddler. It also is known as abusive head trauma, shaken impact syndrome, inflicted head injury or whiplash shaken infant syndrome.

Shaken baby syndrome can damage or destroy a child's brain cells. This form of child abuse can cause permanent brain damage or death.

Shaken baby syndrome is preventable. Help is available for parents who are at risk of harming a child. Parents also can teach other caregivers about the dangers of shaken baby syndrome.

Symptoms of shaken baby syndrome may include:

• Extreme fussiness or irritability.
• Difficulty staying awake.
• Breathing problems.
• Poor eating.
• Vomiting.
• Pale or discolored skin.
• Seizures.
• Paralysis.
• Coma.

While sometimes a child may have bruising on the face, you may not see signs of physical injury to the child's outer body. Injuries that might not be seen immediately include:

• Bleeding in the brain and eyes.
• Spinal cord damage.
• Fractures of the ribs, skull, legs and other bones.

Children with shaken baby syndrome often show symptoms of prior child abuse.

In mild cases of shaken baby syndrome, children may appear OK after being shaken. But they may develop health or behavioral problems over time.

When to see a doctor

Seek help right away if you suspect your child has been injured by violent shaking. Call 911 or your local emergency number or take your child to the nearest emergency room. Getting medical care right away may save your child's life or prevent serious health problems.

Healthcare professionals are legally required to report all suspected cases of child abuse to state authorities.

Babies have weak neck muscles and can't support the weight of their heads. If a baby is forcefully shaken, their brain moves back and forth inside the skull. This causes bruising, swelling and bleeding.

Shaken baby syndrome usually occurs when a parent or caregiver severely shakes a baby or toddler due to frustration or anger. It often happens because the child won't stop crying.

Shaken baby syndrome is not caused by bouncing a child on your knee or minor falls.

These things may increase the risk that parents or caregivers might forcefully shake a baby and cause shaken baby syndrome:

• Having unrealistic expectations of babies.
• Having a baby that cries uncontrollably.
• Having a baby born prematurely or with medical needs.
• Being a young or single parent.
• Stress.
• Domestic violence.
• Alcohol or substance misuse.
• Unstable family situations.
• Depression.
• A history of mistreatment as a child.

Also, men are more likely to severely shake a baby hard enough to cause shaken baby syndrome than women are.

Even brief shaking of an infant can cause brain damage that can't be reversed. Many children affected by shaken baby syndrome die.

Children who survive shaken baby syndrome may require lifelong medical care for conditions such as:

• Partial or total blindness.
• Delayed development.
• Troubles with learning and behavior.
• Seizures or epilepsy.
• Cerebral palsy, a disorder that affects movement and muscle coordination.

New parent education classes can help parents better understand the dangers of violent shaking. The classes also may provide tips to soothe a crying baby and manage stress.

When your crying baby can't be calmed, you may be tempted to try anything to get the tears to stop. But it's important to always treat your child gently. Nothing justifies shaking a child.

If you're having trouble managing your emotions or the stress of parenthood, seek help. Your child's healthcare professional may offer a referral to a counselor or other mental health professional.

If other people help take care of your child, make sure they know the dangers of shaken baby syndrome. These people might include a hired caregiver, sibling or grandparent.

A child who's been forcefully shaken needs to be examined by many different medical specialists, as well as an expert in child abuse.

The healthcare professionals examine the child and ask questions about the child's medical history. Various tests may be needed to detect injuries, including:

• Skeletal survey. Several X-rays of the bones may be used to determine whether fractures are accidental or intentional. X-rays may be taken of the arms, hands, legs, feet, spine, ribs and skull. Such testing also can help find previous fractures.
• Eye exam. An eye exam can reveal bleeding in the eye and other eye injuries.
• Blood tests. Some metabolic and genetic conditions, as well as bleeding and clotting conditions, can cause symptoms similar to those of shaken baby syndrome. Blood tests can help rule out some of these conditions.
• MRI scan. MRI uses a powerful magnetic field and radio waves to create detailed images of a child's brain and spine. It can show brain bruising, bleeding and signs of decreased oxygen. Because an MRI is difficult to perform on a child who's unstable, it's usually done 2 to 3 days after the injury.
• CT scan. A CT scan uses X-ray images to provide cross-sectional images of the body. A scan of the brain can help detect injuries that need urgent treatment. A scan of the abdomen also may be done to determine if there are other injuries.

Depending on the extent of the injuries, the baby may need to be monitored in a pediatric intensive care unit.

Emergency treatment for a child who has been shaken may include breathing support and surgery to stop bleeding in the brain. Some children may require medicines to reduce brain swelling and prevent seizures.