It can also be called head trauma due to child abuse. It is a severe brain injury that occurs due to severe shaking in infants (infants between the ages of 1-2). It is rarely seen after the age of 2, but even at the age of 5-6, damage can occur if the child is shaken violently enough. .
In shaken baby syndrome, the baby's brain cells are damaged so severely that they cannot use enough oxygen. It is a condition that occurs as a result of child abuse and can result in death or permanent brain damage.
Shaken baby syndrome can be prevented. Parents who have the potential to harm their babies can be helped and educated about the dangers of shaken baby syndrome.
Why do people shake babies? It is important to find the answer to the question.
Parents or caregivers think that babies will stop crying when shaken. Parents may be unaware of what it really means to care for a child and may not be able to keep their frustrations and unhappiness away from their children. Many parents are not aware of the terrible consequences of shaking the baby, but very bad consequences may await shaken babies.
Signs of shaken baby syndrome:
Extreme restlessness, high-pitched crying, tendency to sleep, respiratory problems, poor nutrition, tremors, vomiting, breathing difficulties, pale or bluish skin, seizures, paralysis, coma may be observed.
With shaken baby syndrome. Related physical changes: Marks due to strong holding, squeezing, impacts on the body, traces of trauma on the head; swelling, laceration on the scalp, deformity, and retinal hemorrhages in the eye. Signs of previous abuse may be detected.
In mild shaking, the baby may initially appear normal, but over time, learning and behavioral problems may occur. Brain, eye, spinal cord damage, spine and rib fractures may not be noticed at first.
With appropriate treatment, the child's life can be saved and permanent health problems can be prevented.
Causes of Shaken Baby Syndrome.
Since babies' neck muscles are weak, I cannot carry the baby's head. It is difficult to act. When the baby is shaken violently, the brain moves backwards and forwards in the skull, the vessels rupture, bleeding into the brain occurs and the brain swells (Figure 1).
Generally, caregivers and parents of the baby become angry and violent, especially when the child does not stop crying. They shake.
Bouncing the baby on the knee or mild falls do not cause this situation.
Figure 1.
Parents and family-related risk factors
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Unrealistic expectations about the baby
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Being a young or single mother or father
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Stress
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Presence of domestic violence
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Alcohol or substance addiction
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Frequent variations in family conditions
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Depression
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Low education level, inadequacies and disorders in family ties and relationships
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Economic, nutritional infrastructure and stress situation of the family
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Mental illness in the parents, especially postpartum depression
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Inadequacy in social support.
Risk factors for the baby:
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Premature birth, malformed twin babies birth of triplets or more babies
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Babies who suffer from gas pains are babies who cry a lot in the first months of their lives.
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Male gender
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Unintended pregnancy
As a result, irreversible, lifelong damage may occur in babies who are shaken violently, even for just a few seconds. Some children affected by shaken baby syndrome also die.
Lifelong medical problems in babies exposed to shaken baby syndrome:
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Partial or complete blindness
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Hearing loss
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Developmental delay, learning problems, behavioral disorders
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Mental retardation
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Seizures
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Cerebral palsy
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Scars that do not disappear on the skin
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Emotional disorders
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Death
Babies who are shaken violently should be examined by experts and especially It should be evaluated by physicians who are experts in child abuse. Depending on the severity of the damage, the baby may need to be monitored in the intensive care unit. Many tests may be required to detect damage to the shaken baby. Brain computed tomography may be necessary, especially in determining urgent interventions. Magnetic resonance imaging is effective in detailed imaging of damage to the brain. It should be applied 2-3 days after the damage. X-rays of the arms, hands, legs, feet, ribs, spine, and cranium may be taken to check for fractures. Bleeding at the base of the eye may be accompanied by cerebral hemorrhage; an ophthalmological examination should be performed. Some metabolic and genetic disorders, tendency to bleeding and coagulation disorders can create a picture similar to shaken baby syndrome. Therefore, necessary blood tests should be performed.
Three basic findings are essential in the diagnosis of Shaken Baby Syndrome:
1.Single or multiple subdural hemorrhages (bleeding outside the brain surface)
2. Widespread, multiple deep retinal hemorrhages and
3. Widespread brain damage for which no logical explanation can be found and frequently recurring
The damage that occurs when the baby falls is different from what is seen in this table. Even if there are no physical clues in the baby, shaken baby syndrome or abusive head trauma should be considered in the differential diagnosis. Previous fractures and traces of cigarette burns should be investigated. Shaking the baby for just 15-20 seconds is enough to cause this damage.
Fathers are responsible for 50%, stepfather or mother's boyfriend 20%, female babysitters 17% and mothers 12%. .
Treatment and Medications
For treatment, the diagnosis must be made early, and then the baby must be removed from this environment. Supportive treatment and medical treatment should be planned. Surgical procedures for brain hemorrhage, orthopedic treatments for body fractures, and eye treatments for retinal hemorrhages should be planned by experts in the field. Once the baby becomes medically stable, developmental evaluations should be planned and follow-up evaluations should be performed from the moment the diagnosis is made. The abuser's psychological value evaluation should be made. In very serious cases, respiratory support and emergency surgery may be required.
Prevention of Shaken Baby Syndrome
When babies cry, parents need to treat their babies calmly and gently. Nothing justifies shaking the baby. Shaking the baby violently for just a few seconds can cause serious, life-long, irreversible brain damage. A mother or father who cannot manage their emotions and stress needs to get help. Others who care for the baby and take care of the baby should also be aware of the dangers of shaken baby syndrome. It is necessary to ensure that parents and caregivers are educated on all these issues.
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