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Though it often receives very little public attention, shaken baby syndrome is actually the deadliest and most dangerous form of child abuse. Not only does it kill children on a regular basis, but its non-lethal effects can be absolutely devastating, leaving children paralyzed or brain damaged. It’s also one of the more tragic forms of child abuse, because it can happen so quickly in a moment of stress.

“We don’t think that shaken baby is the same kind of child abuse as battered-child abuse,” says Desmond Runyan, a pediatrician at the University of North Carolina-Chapel Hill who specializes in prevention efforts. “It’s somebody who lost it for 30 seconds and changed their life and the life of the child. We’re trying to prevent that unfortunate event.” (Newman, 2008) Awareness of the issue is one of the most important steps in prevention, so please share this page with everyone you know. We also discuss other means of reducing shaken baby syndrome later on.

What is shaken baby syndrome? The mechanics of the injury

A baby’s brain sits upon a bedding of cerebral fluid inside the skull, just like an adult brain. This is designed to cushion their brain against normal, everyday impacts, much like a waterbed. When vigorously shaken, however, the brain can bounce back and forth against the skull. This movement stretches and condenses brain matter, which can damage or tear neurons and the wiring they run along, just as typically happens during a concussion. Shaking a baby can also tear major blood vessels or bruise the brain itself, resulting in life-threatening injuries or permanent brain damage. A brain bleed can easily kill a child, and it can also deprive areas of their brain of blood and oxygen, resulting in brain cell death and permanent brain damage. When it comes to infants and small children, such shaking can also separate the brain stem from the spinal cord, resulting in paralysis or worse.

Infants are at special risk because they are top-heavy and underdeveloped, which means they have far less muscle strength supporting a much bigger and heavier head. Infants don’t even develop the strength to lift their heads until about 4 to 6 months, let alone the strength to keep their head stable while being shaken. This means that being shaken is a much more violent experience. The younger the child, the greater the risk: The incidence of shaken baby cases peak between 2 and 4 months and then steadily declines as children age. There’s no reason to suspect children are being shaken any more or less at older ages, so this early peak likely represents the increased vulnerability that declines as children develop. That said, even children two-years-old or older can experience the same type of damage from vigorous shaking.

It doesn’t take much to injure a child in this way. Obviously, babies do just fine being bounced on a knee. But any type of vigorous or angry shaking can do real damage. If you hold a doll in front of you and shake it roughly for 3 to 5 seconds, that’s enough to cause fatal injuries in a human baby.

Signs of shaken baby syndrome

There aren’t always visible indicators that a baby has been shaken. When they do occur, the signs and symptoms of shaken baby syndrome are similar to those for other neurological damage:

  • Bleeding in the eyes
  • Clear fluid running from the ears
  • Other eye abnormalities, such as extreme pupil dilation, crossed-eyes, eyes that are rolled up towards the back of the head, or a baby that doesn’t focus or react to something in front of them.
  • A baby that was inconsolable before suddenly stops crying for no apparent reason (the sudden lack of fussing is a sign of trauma to the brain).


If you notice any of these symptoms, get the infant to a medical facility immediately.

Additional Information on Shaken Baby Syndrome

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