Shaking syndrome: what it is, symptoms and risks

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Catherine Le Nevez
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It was once called Shaking Baby, that is shaking of the child; today the most correct term chosen by doctors is Abusive Head Trauma, that is, non-accidental head trauma, head trauma caused by abuse.



Because of a abuse these are, and those with the most serious consequences, which can even lead to the death of the child. Unfortunately, the most serious cases are read in the newspapers.

An abuse of which sometimes the adult - usually the mother, but also the fathers or other figures who assist the newborn are not exempt - not even aware, unaware of the damage it can cause shaking the baby by rocking him or in the pram, in an attempt to appease a cry or a 'whim' that seems to never end.



Also read: Shaken Baby Syndrome: 10 Things to Know

An abuse that affects 25 out of 100.000 children

Del Paeseni data on the size of the problem are very scarce, due to the difficulty of distinguishing the shaking syndrome from other forms of mistreatment of which the youngest are victims.



American estimates speak of an incidence of 20-30 per 100.000 children under the age of one, which in 20% has lethal outcomes and in more than half of the cases causes permanent neurological outcomes.

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In this article

 

  • Causes of shaking syndrome: severe stress and loneliness
  • The risks of shaking are very serious
  • Symptoms are hardly visible externally
  • How to avoid: not leaving the new parents alone
  • Newborns should always be handled with care

Causes of shaking syndrome: severe stress and loneliness

"The factor that triggers the impulse reaction of the adult is generally the repeated crying of the child, which cannot be appeased in any way and which increases the load of emotional stress, in a crescendo that can culminate in the extreme gesture of shake it, "he explains Lucia Sciarretta, clinical psychologist and child psychotherapist at the pediatric neuropsychiatry unit of the Gaslini Hospital in Genoa.

"There is no will to do harm and for this reason the adult is not aware of the serious damage that this movement can cause; it is not for nothing that an enormous sense of guilt arises when he realizes it. Most of the time, moreover, he does not these are parents with pathological psychological problems, but people of an impulsive nature, emotionally vulnerable and perhaps already stressed for other reasons, such as economic problems, work, in the relationship with the partner: a combination of factors that go to vent on the child, which it is the weakest link in the chain ".

A very important risk factor is also the loneliness in which the mother finds herself after the birth of her child. At one time people lived close to their families of origin, who gave great support to new mothers, both practical and psychological. Today mothers find themselves almost in a state of isolation: the family is far away or unable to take care of the child, fathers, despite being much more present than in the past, delegate much of the management of the newborn to the mother.

The risks of shaking are very serious

The consequences on the child are variable and depend on the intensity of the maltreatment, but in a high percentage of cases they are very serious.

"Young children, up to 6-12 months, have larger and heavier skulls than the rest of the body, compared to a poor tone and ability to control the muscle structures of the head", highlights Emanuela Piccotti, pediatrician in charge of ready rescue of the Gaslini Hospital in Genoa.

"What's more, the skull is still being consolidated to allow brain development, so the brain structures are more fragile and more vulnerable.

Therefore repeated swaying of the head and neck can cause significant permanent outcomes "such as:

  • brain injuries, which involve cognitive and motor deficits and impaired vision, as hemorrhages are created in the vessels that carry blood to the retina;
  • cases of child death.

Symptoms are hardly visible externally

The lesions are not visible externally and i symptoms, the more marked the smaller the child, they are often non-specific:

  • apnea,
  • convulsions,
  • He retched.

So much so that the parent, unaware of the seriousness of what he did, goes to the hospital to find out what it is. "And in the emergency room the truth comes to the surface a little at a time, with the visit but above all with neuroradiological investigations, like a Brain CT scan or MRI at the level of the skull and spinal cord, and with the often confused and incoherent story of the adult involved "explains Piccotti.

"At that point, if the conditions are met, the hospital medical staff sends a report to the Prosecutor at the Juvenile Court, which, depending on the case, will evaluate how to proceed".

How to avoid: not leaving the new parents alone

  • Don't isolate yourself. The key to preventing such catastrophic consequences is not to leave families alone after the birth of a child: "It is important to act on the social and psychological support of all the figures that revolve around the family: general practitioner, pediatrician, midwife" suggests Lucia Sciarretta. Once the midwife went to the mother's home, now, with cuts in health care spending, this is increasingly rare, just as it is difficult for postpartum courses or psychological and obstetric counseling courses to be organized in the clinic.
  • Even in the absence of specific courses, however, if you realize you are in difficulty, it is important not to keep everything inside, but talk to your doctor about it, ask for help, even material, from those around us, and find out about all the post-partum services that are offered in the area.
  • Carve out spaces for yourself. As much as possible, it should be possible from time to time to create 'relief valves': if you cannot afford a babysitter, leaving the child in custody even for a short time to the grandmother, sister or a trusted friend offers the possibility of being distracted, of emptying the mind and unloading from the accumulated stress.
  • Accept the child as he is. As long as the woman is pregnant, she does not have a real perception of what life will be like after childbirth and she realizes it only when she lives it: she suddenly realizes that she has no time for her anymore, that the baby is not that child. 'happy sleeping angel who was in his dreams, but has moments in which he cries for no reason, regurgitates himself, gets dirty, wakes up at night, throws a tantrum, demands all the attention, like all normal children of his age. Accepting this reality and living it as it is is the first step to better face a period that is very tiring, but will not last forever. Without expecting perfection from themselves.

Newborns should always be handled with care

La shaking syndrome it always derives from a voluntary gesture, repeated and done with a certain force. However, it is important that the caregiver of the newborn knows the basic information on the correct way to handle it.

"At least throughout the first year of life, the head must always be supported, avoiding letting it sway or making it shoot backwards or forwards ", Piccotti emphasizes.

"Furthermore, when you go by car, you need to keep the child in an age-appropriate seat, which adequately supports the head and neck, to avoid the light but prolonged shaking caused by the movement of the car".

Questions and answers

What are the causes of shaking syndrome? 

Generally, severe parental stress and loneliness.

Can the risks of shaking syndrome be serious? 

They depend on the intensity of the maltreatment, but in a high percentage of cases they are very serious.

Are the symptoms of shaking syndrome visible? 

The lesions are not visible externally and the symptoms, the more marked the younger the child, are often non-specific: apnea, convulsions, vomiting.

TAG:
  • first year
  • after childbirth
  • postpartum depression
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