Shaken Baby Syndrome (Abusive Head Trauma)

  • Medical Author:
    John Mersch, MD, FAAP

    Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.

  • Medical Editor: Roxanne Dryden-Edwards, MD
    Roxanne Dryden-Edwards, MD

    Roxanne Dryden-Edwards, MD

    Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

What causes shaken baby syndrome?

The first few months of childhood are tremendously stressful to new parents. Mothers (who often carry more than their fair share of this newly acquired responsibility) are struggling to recover from pregnancy, labor, and delivery as well as deal with an individual who is completely dependent upon them. Breastfeeding mothers may carry an even larger responsibility since they are uniquely responsible for their infant's nutrition. Studies of normal and healthy infants have demonstrated that the number of minutes per day spent crying increases weekly during the first two months of life, stabilizes for three to four weeks, and then drops remarkably. This mixture of physical and emotional parental exhaustion, coupled with what seems to be never-ending crying, can push many over the edge. High-risk infants (premature babies, those with chronic medical conditions, etc.) commonly extract an even higher toll on parents. This may be due to the more demanding requirements of such children and/or a belief of an increase in infant vulnerability. For some caregivers, physical punishment represents the only way to free themselves of their frustrations.

What are the risk factors for shaken baby syndrome?

Risk factors for shaken baby syndrome (as well as other types of inflicted trauma on children) may be conceptualized into two broad categories:

Family risk factors

  1. Young and/or single parents
  2. Lower educational background
  3. Unstable family dynamics
  4. Financial/food/housing concerns and stresses
  5. Domestic violence
  6. Drug/alcohol abuse
  7. Parental mental illness, especially postpartum depression
  8. Limited or no immediate support system (for example, relatives, church groups, etc.)
  9. Unrelated adults staying in the home

Infant risk factors

  1. Perinatal risk factors (for example, threatened miscarriage, prematurity, infant malformations, multiple births (twins, triplets, etc.)
  2. Colicky infants -- often aggravated by the natural history of increase in infant crying during the first two months of life (see above)
  3. Male gender
  4. Unwanted pregnancy
Medically Reviewed by a Doctor on 7/6/2015

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