Parenting: Never shake a baby

Shaking a baby can result in a serious brain injury.

Shaking a baby can result in a serious brain injury.

Janine Gard is a diploma-qualified birth educator (2005) and founder of Bellies to Babies antenatal and postnatal classes. She has helped more than 3700 parents prepare themselves mentally, emotionally and physically for their journey to parenthood and loves what she does. This week Janine talks about Shaken Baby Syndrome.

Shaken baby syndrome is a serious injury to the brain resulting from intentional head trauma which can occur when a baby is thrown, jogged, jerked, or shaken - often because the baby or child won't stop crying. It is the single most preventable cause of serious head injury in babies under one year of age in New Zealand. Babies, especially very young ones, have relatively large heads, and weak neck muscles, so any kind of violent movement will cause a kind of whiplash effect. A baby's delicate, developing brain is much more sensitive to injury and serious damage than an adult's.

Babies also have fragile blood vessels which tear when the baby's brain shifts quickly inside the skull. The build-up of blood in the small space puts pressure on the brain and eyes. Sometimes rough movements can also detach the retina (the light-sensitive back of the eye), leading to blindness along with bruising in their brain, brain bleeding and swelling.

Shaken baby syndrome is more common in children under 2, but it can affect children up to 5. Most cases of shaken baby syndrome occur among babies that are 6 to 8 weeks old, which is when babies tend to cry the most.

Shaken baby syndrome happens when someone

● uses force to shake a baby, infant or child

● uses force to throw or drop a baby, infant or child on purpose

● hits a baby's, infant's or child's head or neck against an object, like the floor or furniture, or hits the head or neck with an object

Shaken baby syndrome symptoms and signs may include

● move less than usual

● be cranky and hard to comfort

● have trouble sucking or swallowing

● eat less than usual

● not smiling or cooing

● seem stiff

● vomiting

● have seizures

● have trouble breathing

● have skin that looks blue

● have pupils (the dark spots in centre of the eyes) that aren't the same size

● be unable to lift their head

● have trouble focusing their eyes or tracking movement

● difficulty staying awake

● coma

Shaken baby syndrome is preventable.

You can avoid harming your baby by not shaking them under any circumstances. It's easy to become frustrated when you can't get your baby to stop crying. However, crying is a normal behaviour in babies and infants, and shaking is never the right response.

It's important to find ways to relieve your stress when your child cries for extended periods of time. Calling a family member or a friend for support can help when you feel yourself losing control. Make sure your family members and caregivers are also aware of the dangers of shaken baby syndrome.

Key points to remember about how to cope with a crying baby.

● crying is how babies communicate - it does not mean your baby is being naughty

● have a plan for what you will do if your baby keeps crying and you become upset or frustrated

● it is never ever okay to shake a baby - make sure that all the people who care for your baby know this

● never leave your baby alone with anyone that you think might lose control

● it's okay to put your baby or child in a safe place, walk away and take a short break

Tips to help you cope with a crying baby

● try feeding your baby; if they don't seem interested, they are not hungry

● change your baby's nappies if they are wet or dirty

● make sure your baby is not too hot or too cold

● try cuddling your baby – they may be lonely or need comforting

● make sure there are no tight clothes on your baby that are hurting them somewhere

● if your baby is showing tired signs, put them down somewhere safe to sleep - tired signs include yawning, rubbing the eyes, fist-sucking, as well as grumpiness

● wrapping and holding your baby safely in a light-weight blanket - many babies love to feel snug

● singing or talking quietly to your baby, or playing some gentle music - babies like soothing noises

● taking your baby for a walk in a front pack or stroller; you could also put your baby in their car seat and take them for a drive - motion generally helps to calm a baby down, and it's good for you too!

● try massaging them gently - this is a great tool to help soothe and settle

● calling a friend or family member - maybe they could come over and give you a break

What should you do if you think your baby has been shaken?

● Take your baby to your nearest doctor straight away.

● Dial 111 within New Zealand for urgent medical help if your baby is unconscious or having breathing trouble.

● Don't let guilt or fear get in the way of your child's health. If your baby has a serious head injury because they have been shaken, it will only get worse without treatment. Early medical attention may save your baby's life and prevent serious long-term problems.

● If your baby seems quite well but is fussy and/or vomiting, it is important that you tell the doctor that you know or suspect your baby has been shaken, so that they can give the proper treatment.

● If the crying wears you out or you find yourself stressed to your limit take a time out. Separate yourself from your baby for a little while. If possible, ask someone else to take over comforting your baby. Put your baby in their crib or another safe place and leave the room. Try calling a friend or doing something you find relaxing such as making a cup of coffee or tea, taking a shower, listening to music, reading or sitting down and closing your eyes. Don't be afraid or ashamed to call for help. Talking to a trusted friend or relative can be enormously comforting as well.

Where can you go to for help if you feel stressed?

Lifeline (phone 24 hours; 0800 543 354 or for callers in the Auckland area 64 9 522 2999)

SHINE helpline: national family violence helpline 0508 744 633. Free and confidential, operates every day 9.00am - 11.00pm

Samaritans (only available in some areas; phone numbers in front few pages of your white pages phone book)

Youthline for young parents (phone 0800 376 633)

Healthline on 0800 611 116 (24 hours a day; every day)

PlunketLine 0800 933 922 (24 hours a day; every day)

Organisations which might be helpful

Barnardos - 0800 BARNARDOS (0800 227627367)

Family Start - available in 36 locations around New Zealand (check the Family Services Directory to find if there's one near you)

Oranga Tamariki, Ministry for Children (previously Child, Youth and Family) - 0508 FAMILY (0508 326 459)

■ Bellies to Babies Antenatal & Postnatal Classes, baby massage courses and baby and infant first aid courses, 2087 Pakowhai Rd, Hawke's Bay, 022 637 0624. https://www.hbantenatal-classes.co.nz/

Medical disclaimer: This page is for educational and informational purposes only and may not be construed as medical advice. The information is not intended to replace medical advice offered by physicians.