Hazel Tan was just 4 months old when her parents rushed her to the Accidents and Emergency unit in a hospital. When she was diagnosed with a brain injury and burst blood vessels in the eye, the doctors suspected that she was a victim of Shaken Baby Syndrome (SBS). Although Hazel was then under a nanny’s care, the police did not take any legal action as they could not find any evidence that she had been ill-treated.
Dr Kao Pao Tang, head & consultant (Children's Emergency) at the National University Hospital, explains that SBS is a serious injury that often proves fatal. “Those who survive it often develop cerebral palsy with varying degrees of disabilities — from quadriplegic to blindness — which carries with it [a myriad of health issues].”
Cerebral palsy sufferers have to deal with a wide range of health issues including frequent respiratory infections, trouble swallowing, limb contractures, urinary tract infections and bedsores if they are bedridden. The muscles of their limbs may also contracted permanently.
“Given enough strength, even a 5-year-old can be shaken to [his] demise.”
Even worse, Dr Kao cautions that babies with SBS seldom show any visible signs of the condition. He notes, however, that the symptoms and signs of SBS are similar to that of meningitis, except that there’s no fever.
Seek emergency help if your infant displays any of the following symptoms:
* Is highly irritable or sleepy and lethargic.
* Has a bulging fontanelle/s — the soft spot where the bones of bubba’s skull have yet to fuse — from the increased pressure in the skull.
* Has trouble breathing
* Has poor appetite.
* Has body tremors and seizures.
* Is vomiting and nauseated.
* The skin appears bluish or pale.
* Bleeding in one or both eyes.
Don’t be fooled by the name of the condition, either — older kids are equally at risk of dying from SBS. Dr Kao cautions, “Given enough strength, even a 5-year-old can be shaken to [his] demise.”
He explains that the medical world now avoids using the term Shaken Baby Syndrome to reflect the life-threatening nature of the condition. The terms abusive head trauma or non-accidental head injury are used instead. He adds, “The change in terminology reflects that the actions leading to non-accidental head injury is not a random or accidental event. [But rather] the result of deliberate violent shaking of an infant.”
Tips on how to guard your kewpie against abusive head trauma, next…!
Abusive head trauma is also likely the result of a frustrated caregiver although there have also been reported cases of intentional abuse. Dr Kao notes, however, that the condition is uncommon in Singapore. So, how do you ensure that your little one doesn’t become a victim of a non-accidental head injury?
1) Don’t shake the baby. At all. Dr Kao says, “It is best to advise caregivers not to shake a baby under any circumstances because gentle shaking can rapidly escalate.” A safer option is to rock your baby gently while he is cradled in your arms.
2) Walk away when you are frustrated. Whenever you find yourself becoming angry and frustrated with your crying baby, put him in his crib and walk away ― there is nothing wrong. Always calm yourself down before attending to the baby again. Dr Kao suggests you call a relative or a friend you can trust for support.
“It is best to advise caregivers not to shake a baby under any circumstances because gentle shaking can rapidly escalate.”
3) Sometimes, it’s the surroundings. Your sweetpea might be crying because he is overstimulated by the loud noises or bright lights of his environment. Reducing these triggers should create a more soothing setting for your child and calm him down.
4) Try different methods to soothe your baby. Dr Kao suggests useful methods to soothe your little one:
* Hold your crying baby against your chest and gently massage him.
* Rock, walk or dance gently with your baby.
* Offer a pacifier or toy to distract him.
5) Learn to soothe your little one. Then teach other caregivers. Abusive head trauma is almost always the result of caregiver frustration, so teaching your caregivers ways to soothe your crying baby will alleviate much of their stress. This should reduce the chances that your child might become a victim of SBS.
Dr Kao Pao Tang is head & consultant of Children’s Emergency at the National University Hospital.