Shaken Baby Syndrome

Nickolaus J. Miehl


J Foren Nurs. 2005;1(3):111-117. 

In This Article

Abstract and Introduction

Shaken baby syndrome (SBS) is a violent act of abuse that can cause myriad neurologic, cognitive, and other functional deficits. In the most serious cases, death can result. Health care practitioners, child care providers, and parents must be educated on the signs of SBS. Cases should be thoroughly reviewed and prevention strategies developed to prevent future incidents.

The maltreatment of children, including nonaccidental trauma, continues to be problematic for children, families, and other care providers. Despite efforts of child protective services and health care providers alike, the maltreatment of children remains an all too common occurrence. According to Tenney-Soeiro and Wilson (2004), an estimated 903,000 children were victims of maltreatment in 2001. It is of particular concern when the maltreatment ends with a fatality; that same year, an estimated 1,300 child fatalities occurred as a direct result of maltreatment. Of these fatalities, 41% occurred in children under the age of 1 year, and 85% occurred in children under age 6. The best estimates on the incidence of physical abuse in the causation of child fatalities ranges from 19% to 30% (Tenney-Soeiro & Wilson, 2004; National Clearinghouse on Child Abuse and Neglect Information, 2004) (see Figure 1).

Child Abuse and Neglect Fatalities by Maltreatment Type, 2002
Reproduced with permission from the National Clearinghouse on Child Abuse and Neglect Information. (2004). Child abuse and neglect fatalities: Statistics and interventions.

Challenges in detecting and reporting SBS cases have been difficult to overcome, thus the true incidence rate is unclear. There is no centralized reporting system for SBS which can lead to the underreporting of this particularly severe form of maltreatment. Additionally, SBS is typically not an isolated event; rather it may be part of a more chronic pattern of maltreatment. SBS victims can present with a wide range of symptoms, from generalized flu-like symptoms to unresponsiveness with impending death.

Obvious signs of maltreatment may not be present. Detecting this type of maltreatment requires the careful attention of the health care practitioner in the community-based, primary care, and acute care settings to ensure the proper care of the victim, appropriate counseling for the family, reporting of correct information to law enforcement officials, and prevention of repeat occurrences.


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