It's called Shaken Baby Syndrome (SBS) and it's a phenomenon often ignored by parents and underestimated by pediatricians. Yet it entails serious outcomes for the newborn and for its future. Also known as 'abusive head trauma', it concerns children under the age of 2 – especially a few months old – and refers to a form of physical abuse generally perpetrated in a family environment. John Caffey - the doctor who first discovered SBS in 1946, and then formalized the definition in 1972 - noted, in children shaken violently and repeatedly to compensate for their inconsolable crying, the emergence of a trauma on the brain and subsequent damage neurological.
The causes
The arrival of a baby brings joy and excitement, but also an entirely understandable set of worries and a lot of stress. From its entry into the world, from its first cry, the little one reveals himself for what he is: a defenseless being who needs constant care, love and great attention, an exorbitant dose of availability from his parents - or grandparents, babysitters and educators – who have to feed, look after, reassure, pamper and protect him. Becoming a parent can be a wonderful and disruptive shock, and it takes a lot of patience to take on this responsibility.
A patience that certain explosions of irrepressible crying can put to the test. It then happens that, to appease the screaming baby, mum and dad, helpless and impatient, act on him with inappropriate and often completely unconscious consolatory manoeuvres, such as shaking, which is harmful even if it lasts only for a few seconds (nothing to do with , however, with the rocking, even insistent but gentle, which is usually used to rock the baby and help it calm down and fall asleep).
The consequences on the child
In the newborn and very young child, the neck muscles are still fragile, unable to support the head properly. A jolt therefore implies that the brain, moving freely in the skull, suffers a trauma, with bruising, swelling and bleeding of the tissues. These are very serious injuries, which involve neuropsychological damage: learning, attention, memory and language disorders, damage to sight or blindness, hearing disabilities, cerebral palsy, epilepsy, psychomotor and mental retardation. The consequences depend on the seriousness of the abuse: it is estimated that only in 15% of cases there are no repercussions on the child's health. In a quarter of diagnosed cases, SBS leads to coma or death. As for the symptoms, we speak of vomiting, inappetence, difficulty in sucking or swallowing, extreme irritability, lethargy, absence of smiles or vocalizations, rigidity, difficulty breathing, excessive increase in head circumference, poor control of the head, frequent inconsolable crying and, in more severe cases, convulsions, unconsciousness and cardiorespiratory arrest.
Incidence and risk factors
Since the diagnosis is complex and certain epidemiological data are lacking at both European and Italian level, the incidence of the phenomenon is difficult to estimate. In our country, 3 cases are assumed for every 10,000 children under one year old, but it could be more. In 2017, 6 cases of SBS were recorded in the Regina Margherita Hospital of Turin alone. The peak is found between 2 weeks and 6 months of life, ie when the crying of the newborn is greater (and more difficult to understand) and the control of the head is less. According to data released by the Italian Society of Neonatology, the main risk factors are the following: underage mother, single-parent family, low level of education, alcohol or drug abuse, unemployment, family violence and social hardship. Very often, however, the cause can only be traced back to the exasperation of the parents.
Based on Born Mom by Mattia Lerner
