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Abusive Head Trauma (Shaken Baby Syndrome)

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KEY POINTS

  • Abusive head trauma (AHT) is a medical term for brain injuries caused by shaking, hitting, slamming, dropping, or throwing a baby. These actions are considered child abuse. They can damage a child’s brain and cause a lack of oxygen, severe mental and physical problems, and even death.
  • A child with AHT needs to be treated in a hospital. The goal is to stop any further brain damage. Treatment depends on your child's injuries.
  • NEVER shake, slam, hit, drop or throw a baby. Don’t leave your baby with someone who is drinking or using drugs, or who may be angry or violent. Use only childcare providers who are licensed.

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What is abusive head trauma?

Abusive head trauma (AHT) is a medical term for brain injuries caused by shaking, hitting, slamming, dropping, or throwing a child. These actions are considered child abuse. They can damage a child’s brain and cause a lack of oxygen, severe mental and physical problems, and even death.

It is also called shaken baby syndrome.

What is the cause?

Usually babies are shaken by a parent or a caregiver, but it can be done by any adult. People caring for the baby may get angry or frustrated, often because the child is crying.

Gently bouncing a baby in play does not cause shaken baby syndrome.

What are the symptoms?

A baby who is a victim of AHT may:

  • Have a change in behavior such as being sleepier than usual or being very fussy
  • Not eat well
  • Vomit
  • Have seizures
  • Stop breathing off and on
  • Be unconscious

Abusive head trauma may cause only mild symptoms at first, but these babies can have severe mental and physical problems for the rest of their lives. Even if a baby looks normal right after the abuse, over time the baby may have problems such as:

  • Blindness
  • Hearing loss
  • A delay in walking and talking
  • Problems with speech, learning, growth, and behavior
  • Seizures
  • Trouble paying attention and remembering things

If you think your baby has been shaken, get emergency care right away. Tell healthcare providers that you think your baby has been shaken. It may save your baby's life.

How is it diagnosed?

A healthcare provider will ask about your child's symptoms and medical history and examine your child. Your child may have tests such as:

  • X-rays
  • CT scan, which uses X-rays and a computer to show detailed pictures of the brain and body
  • MRI, which uses a strong magnetic field and radio waves to show detailed pictures of the brain and body
  • An exam by a healthcare provider to look for evidence of bleeding in the back of the eye (the retina)

How is it treated?

A child with AHT needs to be treated in a hospital. The goal is to stop any further brain damage. Treatment depends on your child's injuries and may include:

  • Oxygen or sometimes, a tube put down your baby’s throat and connected to a machine to help your baby breathe
  • Surgery to treat the bleeding and swelling in the brain
  • A cast or splint for broken bones
  • Medicine for seizures
  • Draining fluid from the baby’s head

Several specialists may care for your baby. Even with prompt treatment, your child may need lifelong medical care.

How can I help prevent abusive head trauma?

  • NEVER shake, slam, hit, drop or throw a baby.
  • If you find yourself getting frustrated or angry with the baby, put the baby in the crib or another safe place and leave the room until you calm down or until help arrives. Before you leave the room, make sure the baby is safe. For example, remove pillows and stuffed animals from the crib. If you place the baby in an infant carrier, make sure the carrier cannot fall off a bed or is not close to stairs.
  • If you feel that your baby is crying too much and you cannot cope with the crying, get help. Call a friend or relative for support or to take care of the baby for a little while. Also call your healthcare provider. After hours, go to the emergency department or urgent care center. There may be a medical reason why your baby is crying.
  • Don’t hold your baby during an argument or fight.
  • Don’t leave your baby with someone who is drinking or using drugs, or who may be angry or violent.
  • Use childcare providers who are licensed. Check their references before you leave your child with them. Make unannounced visits at different times of the day.
Developed by Change Healthcare.
Pediatric Advisor 2019.4 published by Change Healthcare.
Last modified: 2019-10-31
Last reviewed: 2019-10-17
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2018 Change Healthcare LLC and/or one of its subsidiaries
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