Nutrition and diets 

What happens if you shake your baby too hard. If the child continues to cry. When and how the body of a newborn can shake: symptoms of tremor of the chin, limbs, lower lip

"Each of you is responsible for
what is entrusted to him" (Bukhari and Muslim)

"The majority infants affected by injury,
resulting from strong shaking,
persisting neurological deficits
and more than 25% of them die"
(A. G. Rumyantsev, O. N. Dreval,
V. M. Feniksov)

Ambulance delivered six month old baby in hospital. He responded poorly to sound and tactile stimuli. Suddenly, after convulsions, he stopped breathing, there was a loss of consciousness. emergency measures did not help, and the child died. An autopsy showed that the cause of death was that the night before the mother shook the child violently, because he cried long and hard, and her nerves could not stand it.

Back in the seventies of the last century similar cases were noted by medical scientists in the United States, and the disease itself was called a syndrome baby concussion(SDS) (Shaken baby syndrome - SBS, Sudden infant death syndrome - SIDS). SDS was first described by pediatric radiologist John Caffey in 1946, and in 1974 he coined the term WSIS (“whiplash shaken infant syndrome”).
SDS occurs when an adult shakes the baby so hard (a few seconds is enough) that the unfixed head dangles, which ruptures the membranes of brain cells and damages the brain as a whole. The symptom manifests itself in hemorrhages, cerebral edema and hemorrhages in the retina. Consequences - mental retardation, paralysis, blindness, epilepsy. In the worst case, the baby may die.

By modern ideas SDS is one of the leading causes of infant death. In the USA, for example, 2,000 babies die from it every year, in England - 100. Globally, there are an average of 27 cases of SFS per 100,000 babies. For many countries, accurate data are not yet available. Based on studies conducted in the United States and England, fathers-stepfathers (68-83%) are most often responsible for SDS, followed by nannies (8-17%) and mothers (9-13%).

A lawsuit related to the SDS took place in Switzerland. Renowned climber Erhard Loretan has been accused of inadvertently killing his seven-month-old son. On Christmas Eve, Loretan was left alone with the baby. The child did not want to fall asleep and cried for a long time. Losing patience, and not knowing how to appease his son, Loretan took him with both hands and shook him slightly. The screaming stopped, the father put the baby back on the bed and left the room. In the morning he discovered that the child was unconscious. A day later, the baby died in the hospital. The court sentenced the father to a suspended sentence and a fine for the unintentional murder of his son. This case received wide publicity, and since then not only doctors, but also lawyers have paid close attention to SDS.

In 2003, the first VTS congress was held in Edinburgh. Estonia, for example, was one of the first countries in Eastern Europe to become aware of the shaken baby syndrome. In this country, the syndrome was first diagnosed in 1999, its frequency is 40.5 per 100 thousand population. Pediatric neurologist clinic of the University of Tartu Inga Talvik defended her first doctoral dissertation on SDS. There have already been a number of criminal investigations into the SDS.

It is possible to significantly reduce the incidence of such a disease and the death of infants.
To do this, child psychologists and pediatricians recommend:
Never, for any reason, shake a child who has not reached the age of two.
When you hold a newborn in your arms, support his head.
It is important to understand that the child is not crying because he wants to piss you off. He may be hungry, sick, or for other important reasons.
If the child does not stop screaming, then go out for a few minutes to another room. When you calm down, then return to him to finally deal with the situation.
Over time, the child will grow up and stop screaming. In the meantime, you need to deal with this situation without losing your composure.

The main reason why parents lose self-control is the crying of the baby. In addition, parents lose their temper when the child does not want to eat or sit on the potty. It needs to be explained that crying baby- it's not a problem that crying is the "work" of the child, he will not die from this, but he can die from a concussion. Parents should remember that even slight shaking of the baby leads to such damage to his brain, from which 10-20% of infants die, and 75% receive brain injuries for life with unpredictable consequences throughout their lives.

x x x
Passed by recently kindergarten. A young mother and son went out into the street. Their relationship has clearly deteriorated. Suddenly, mother from all over hit the boy in a soft spot. He cried so loudly that a flock of sparrows flew away in an instant. If the child were younger, then SDS would be guaranteed from such a shake-up. Extensive explanatory work of psychologists and doctors among future parents is needed to prevent the risk of developing SDS in infants. Need and timely diagnosis syndrome, if such a misfortune happens to the baby.

P.S.
Than to beat a child, it is better to stroke him affectionately. Studies show the benefits of this:

The prestigious $100,000 Alberta Heritage Foundation award went to Canadian scientist Michael Meaney for his study of how parental touch can help reduce stress in offspring by changing chemical processes in the brain, which turn on the gene responsible for relieving stress.

According to the BBC broadcaster, a professor at McGill University conducted the first phase of his study on laboratory rats. Among those who licked the fur of their offspring more often, the babies were calmer and less shy compared to those who were less attentively cared for. In addition, carefully groomed offspring were better able to perform some of the tasks that the experimenters set for them.

“We tried to understand the intermediate stage that is between the risk of a disease and the actual disease in the future,” said Professor Mini in an interview with the television company. “After all, the conditions when children become predisposed to obesity, diabetes or cardiovascular diseases. We are trying to identify methods of interaction between parent and child that could reduce the risk of this kind of disease" ( medical news 16.02.08 Solvay Pharma)

-----
See also:

* Diagnosis of the new time - shaking baby syndrome http://rus.postimees.ee/051007/glavnaja/estonija/23161.php
* SDS Syndrome http://www.raspm.net/d/raspm_nauka_info_01.pdf
* Shaking a child is dangerous! http://islam.com.ua/gazeta/0401/opasno.shtml
* Concussion in children http://www.7ya.ru/articles/8060.aspx
* Leading cause of infant death in Israel http://www.netvestnik.com/news-28129.html
* Shaken Baby Syndrome (SBS) * Caffey J. The Whiplash shaken infant syndrome: Manual shaking by the extremities with whiplash-induced intractanial, and intraocular bleeding, linked with residual permanent brain damage and mental retardation. Pediatrics 1974; 54:390-400.

"Happy child"Family photo

Reviews

Vlad, thanks for the topic, it is interesting and relevant: I have never heard of such a syndrome. I absolutely agree that explanatory work should be carried out. After all, the lack of information leads to tragedies.
Mom of a three-month-old Platoshka,

How many parents know what Shaken Baby Syndrome is? And why can't you shake the baby, why can't you throw the baby up or throw him on the bed? All of these actions can lead to grave consequences up to lethal!

Shaken baby syndrome (SBS) is also known as postconcussion syndrome, shaken baby syndrome, shaken baby syndrome, shaken baby syndrome. All these names mean the same thing: brain damage as a result of a head injury in a child.

Shaken baby syndrome (SBS) can be the result of blows to the head, a baby being thrown or dropped, or violent shaking.

SDS is one of the leading causes of infant death in the United States. Due to their special anatomy, infants are prone to big risk from these actions, so most of the victims are children under one year old.

But SDS can also be found in children under 5 years of age, although average age for diseases - from 3 to 5 months. The peak falls at the age of 6-8 weeks, the time when babies cry the most.

Methods of injury

Shaken baby syndrome occurs as a result of injury caused by someone (most often a parent or someone who looks after the child). The cause is a strong shaking of the child or a strong blow to the head.

In most cases, the one who looks after the child and cannot calm his crying in any way begins to shake him out of anger or hopelessness. Unfortunately, such actions can lead to a completely undesirable effect: at first, the child screams and cries even more, and then it can stop abruptly, because the brain has been damaged.

If there are several children in the family, there are children with special needs, colic or GERD, their chances of developing SDS are increased. Boys are more likely to suffer from the disease than girls, and children living in low-income families or below the poverty line are more likely to have both SDS and other types of childhood trauma from parental abuse.

Males are responsible for 70% of child injuries- fathers or stepfathers, often young age. But any person who is not able to cope with emotions and overcome anger, and who is also prone to the use of force, can resort to shaking the child vigorously in order to calm him down. Alcohol abuse is also a common cause of SDS.

When a person shakes the baby vigorously, the loose head dangles because the weak neck muscles are not yet able to properly support the head. As a result, the child's brain is also not in a static state, the membranes of brain cells are torn, blood vessels are torn and tissues are damaged. All this can provoke a hemorrhage under the lining of the brain.

The situation can be aggravated by such an adult action as throwing the child with force onto the bed. Swelling in the brain due to violent shaking can cause internal pressure, compress blood vessels and further injure the baby's fragile brain.

Habitual games with children, light tossing or tossing a child on his knee, does NOT lead to this injury. But under no circumstances should you shake a child.

Concussion Syndromes: Consequences

SDS leads to irreversible consequences, and in 1 out of 4 cases leads to the death of a child.

The consequences may be:

  • complete or partial blindness;
  • hearing loss;
  • epilepsy;
  • mental retardation;
  • speech disorders and learning problems;
  • problems with memory and attention;
  • severe mental retardation;
  • paralysis.

Even if, after a strong shaking, the child looks absolutely normal outwardly, after a while one of the symptoms mayafter allshow up. Most often, the problem occurs withoutanyoutward signs of damage, and problems with behavior, memory, or learning become apparent only during the period when baby goes to school.

But by that time it is already difficult to judge the connection of such violations with the actions of parents many years ago.

Shaken Baby Syndrome: Symptoms


Each case of SDS depends on the severity and duration of exposure, frequency of use of force, and possible other forms of brutality. In the most horrific cases, children are admitted to the traumatology department unconscious, in a state of shock or seizure. But in most cases, since severe symptoms do not appear immediately after injury, children are not subjected to examination.

Shaken baby syndrome symptoms to watch out for:

  • lethargy;
  • irritability;
  • vomit;
  • inability to swallow;
  • loss of appetite;
  • bad mood and quiet behavior;
  • rigidity;
  • seizures;
  • respiratory failure;
  • turning blue due to lack of oxygen;
  • loss of consciousness;
  • unequal pupil sizes;
  • unable to raise head;
  • inability to focus or move.

Shaken Baby Syndrome: Diagnosis

Most cases of SDS are viewed as "causeless injuries". In other words, parents and caregivers often can't link DFS to trauma or shaking, so doctors can't immediately diagnose the disease. Thus, a child's injuries can often be untreatable medical analysis or not identified by experts.

In many cases, children without serious consequences or impairments do not receive medical examination. Symptoms such as vomiting and irritability, for example, may be unrelated to the injury and may subside over time.

Unfortunately, in cases where the doctor has no suspicions abuse with a child, symptoms such as lethargy, fussiness, or lack of appetite are mistaken for a virus or colic. That is, the lack of suspicion of child abuse by parents or caregiver may cause further repetition of forceful acts and worsening damage to the child's brain.

If doctors suspect SDS, the signs are:

  • retinal hemorrhages;
  • skull damage;
  • cerebral edema;
  • subdural hematomas (blood clots press on the surface of the brain);
  • broken ribs and long bones(bones in arms and legs);
  • bruising around the head, neck, or chest.

Development and education of a child with shaken baby syndrome


The reason SDS is so serious and devastating is that it often causes a general head injury. For example, a child who has a severely impaired vision will not be able to use his vision to study the world around him, therefore, the child's overall ability to learn is sharply reduced.

The development of speech, vision, balance and coordination can also be felt Negative influence SDS. Such impairments may require intensive physical and occupational therapy to help the child acquire skills that would have developed normally if he had not had a traumatic brain injury.

As these children mature, they may require individualized instruction and ongoing language and general therapy to help with the simplest daily tasks.

How to Prevent Concussion Syndromes

There is a 100% chance of preventing shaken baby syndrome. The basis for this is the awareness of the population about the potential threat of shaking a child.

Possible ways to alleviate the stress of parents and caregivers at critical times can also significantly reduce the risk of SDS in a child. Exists special programs at hospitals, through which parents learn how to respond to children's crying and what is fraught with the use of force against a child.

The All Children Cry in the USA national program informs the population about ways to overcome parental anger and irritation at children's crying and promotes healthy parenting children. The program has four categories:

  1. Why is crying normal?
  2. How to calm a child
  3. parental psychology
  4. How to deal with colic

There is also a special program that helps parents understand and accept the causes of children's crying, and also suggests ways to stop it.

Sh-P-methodS-P-K


Sh-noise: white noise or other noise similar to what the baby heard while in the womb. A vacuum cleaner, hair dryer, dryer, tap water or a special apparatus for creating white noise will help you.

P-positionlying down or on the side:(position on the left side - to help the child digest food, on the stomach - while the parent holds the child, on the back - sleep)

C- nipple: breastfeeding, bottle, nipple or finger

P-swaddling: a child wrapped in a blanket like a "burrito" will help him feel safe. Hips and legs may be outside or slightly covered.

K-swing: rocking gently in a chair, in a cradle, or driving a car can help the baby feel similar vibrations that they experienced while in the stomach.

If the baby keeps crying

If the baby continues to cry, try the following:

  • make sure the baby is full and does not need to change the diaper;
  • check whether the child is not sick;
  • shake or scold the child in your arms;
  • speak or sing to the child;
  • give your child a pacifier or a toy;
  • give your child a ride in a stroller or in a safe child seat in car;
  • hold the child close to you and breathe slowly and calmly;
  • buy in a warm bath;
  • stroke the child's back;
  • ask someone to help you rest and look after the baby;
  • if there is no result, put the child in the crib, close the door to the room and observe his behavior for 10 minutes.
  • call the doctor if the baby does not stop crying, as there may be a medical reason for this.

To prevent SDS, parents and caregivers need to learn how to control their stress. It is important that the caregiver knows not to shake him under any circumstances about the dangers and consequences of childhood trauma.

Many parents, noticing in a newborn child frequent and small twitching of the lips, chin, mandible, arms or legs, they often wonder if these twitches (tremors) can be considered the norm. Tremor- this is a compensatory reaction of immature nerve fibers of the baby in the form of small muscle crampsthat occur to stabilize the condition nervous system. It can be physiological and pathological.

Physiological tremor small in its amplitude, it is rhythmic and often occurs during the crying of the child. With tremors in newborns, the lower lip or chin is more likely to tremble, and in rare cases, the arms or legs. Trembling can manifest itself asymmetrically and symmetrically. For example, one knob or both may tremble.

Distinctive features physiological tremor are:
1. His rapid disappearance (after a few seconds);
2. Appearance after nervous tension(bathing in the bathroom, intestinal colic, crying, changing clothes, phases of REM sleep or when feeling hungry, etc.).

Most often, physiological tremor appears in the first days of a baby's life, and gradually its episodes become more and more rare. Tremor symptoms are especially pronounced in premature babies because their nervous system is more immature than that of full-term newborns. As a rule, physiological tremor completely disappears before 1-3 months of life.

Pathological tremor differs from the physiological one in that not only the lips, chin and limbs of the baby, but also the head are involved in the process of twitching.

Episodes of pathological tremors become longer over time and occur for no reason, and twitches become more intense and can spread to the whole body. The baby becomes more restless, moody and does not sleep well.

Such a condition of the child should alert parents and become a reason for a visit to a neurologist, since pathological tremor can be a symptom of neurological diseases and disorders (increased intracranial pressure, intracranial hemorrhage, hyperglycemia, hypomagnesemia, hypocalcemia, perinatal encephalopathy, etc.).

Causes

The main cause of tremor of the lips, chin, upper and lower extremities in a newborn child, there is an immaturity of some nerve centers of the brain and a high content in the blood serum of the hormone of the adrenal glands - norepinephrine, which is responsible for the transmission of nerve impulses. Physiological tremor occurs in the majority (about half) of newborns under 1 month of age and in almost all premature babies.

The main predisposing factors for the underdevelopment of the nervous system of the baby are: oxygen starvation and an excess amount of norepinephrine in the blood of the expectant mother. The reason for the development of such conditions can be a variety of factors:

  • fetal hypoxia during pregnancy;
  • stressful situations mothers during pregnancy;
  • the threat of termination of pregnancy;
  • infectious diseases in the mother;
  • rapid childbirth;
  • cord entanglement;
  • trauma during childbirth.

Treatment

Physiological tremor The child does not require medical treatment. Neurologists recommend that the baby's parents carefully monitor the baby to find out the moments when he begins to tremor - at rest or with nervous excitement.

With pathological tremor treatment should be carried out under the strict supervision of a neurologist. After determining the cause of the tremor, the doctor may prescribe medications to treat the underlying disease.

In addition, such children are prescribed therapeutic exercises and relaxing massage. These procedures should be carried out by a specialist, he can also teach some skills to the mother of the baby. Nice results they give swimming lessons, as well as the creation of a friendly and calm atmosphere in the family.

Massage for tremor in a newborn

Massage for tremor in a newborn is recommended to start doing from 5-6 weeks of age. It is relaxing and restorative in nature and helps to strengthen the nervous system of the baby. Massage should be performed by an experienced massage therapist; subsequently, the mother of the child can also learn massage techniques.

Recommendations for massage with tremor in a newborn:
1. Ventilate the room before the session.
2. Hands should be clean, warm and dry, nails cut short.
3. The session is carried out at a time when the baby good mood and he is awake.
4. Perform the session on a flat surface, in a comfortable and familiar place for the baby (for example, on a changing table).
5. During the massage, it is necessary to talk with the child.
6. Massage must be stopped if the child cries or somehow shows his displeasure.
7. Do not use for massage aroma oils or baby powder (you can use the usual baby cream).

For a relaxing massage, the following movements can be used:

  • stroking;
  • kneading;
  • trituration;
  • vibration.
Each massage session for a newborn should begin and end with stroking. All movements should be smooth and pleasant for the baby. Movement should be directed along the course of the joints (from the periphery to the center or from bottom to top). The force of pressure is determined by a specialist and, in the event that the massage is carried out by the mother of the child, he must definitely teach her this subtlety.

When performing a relaxing massage, it is important to follow a certain sequence:

  • first, the handles are massaged - the child’s handle is held with the left hand (by the brush), and stroking is performed with the right hand (10 times), gentle rubbing of each finger is performed, then the other handle is massaged;
  • massage chest- put the palms of the hands on the base of the neck and stroke down ("herringbone"), repeat 6-7 times;
  • tummy massage - palm right hand put on the baby's stomach and do circular motions clockwise, perform about 10 times;
  • foot massage - performed in the same way as hand massage;
  • back massage - the baby, holding the arm and leg, is turned over on the tummy, stroking from the bottom up, then herringbone.
The duration of the massage and the types of massage techniques depend on the age of the child. For babies 1.5-3 months old, it is 4-5 minutes. The number of procedures is determined by the doctor, depending on the condition of the child.

Consequences

Physiological tremor does not leave negative consequences for

The piercing cry of a baby can be very annoying for parents. In such a situation, an adult takes the child, and, in order to stop the cry, begins to shake it. This is where a tragedy happens that adults are not even aware of. According to statistics, the mortality rate from shaking within 15-20 seconds reaches 15-38%. And the surviving children may develop blindness, deafness, convulsive seizures, hydrocephalus, children's cerebral paralysis and learning disabilities.

The baby's head is the largest and heaviest part of its body, accounting for 10-15% of its mass (in adults - only 2-3%). And the skull is thin, has an open fontanelle, the sutures and bones are not completely ossified. The muscles of the neck are weak, which contributes to the high mobility of the head in all directions.

The combination of a large, heavy head and a thin, weak neck makes a child especially susceptible to acceleration-and-deceleration injuries, in which an adult grabs the child by the shoulders or under the armpits and begins to shake violently, which causes flick baby's head back and forth.

The child has long processes in the brain nerve cells not yet mature, their shell is not complete, as a result of which they can easily break off. When shaking, a large amount of fluid in the brain substance additionally increases the risk of neuron breakage, the so-called "shearing" injury.

Violent shaking exposes the baby's head to tremendous force, similar to that experienced in high-speed car accidents. At the same time, ruptures of blood vessels passing through the membranes of the brain also occur, causing subarachnoid or subdural bleeding. Shaking causes hemorrhages in the retina, while the blood vessels are literally cut off from it.

Throwing the child up and intense motion sickness in the stroller can also lead to the development of shaken syndrome.

Research has shown that these are the most common causes childhood injuries, such as falls from a crib, table or chair that are less than 1.25 m high, rarely cause significant injury.

Shaken baby syndrome often masquerades as another disease or disorder. For example, you may not understand why baby suddenly became irritable, sleeps badly or vice versa drowsy and lethargic. There are a number of other manifestations of the syndrome: these are convulsions, and a decrease muscle tone, and loss of appetite, bulging large fontanel, fever and even vomiting.

If, after intense motion sickness, the child has at least one of the listed symptoms, you should immediately help him. Need to urgently call an ambulance medical care. If the child has stopped breathing, then cardiopulmonary resuscitation should be performed before her arrival.

If vomiting occurs, if there is no suspicion of a spinal injury, the child's head should be turned to the side to prevent choking and aspiration, if this is suspected, the entire child should be turned on its side as a whole in order to protect the neck.

1. NEVER shake an infant, whether during play or in anger;
2. NEVER hit an infant in the face or head;
3. NEVER leave an infant;
4. Don't toss the baby up;
5. Do not shake the baby in the stroller;
6. If you feel that the crying of the child irritates or enrages you, put him in the crib and leave the room, try to calm down; contact someone for support;
7. If you feel that you are losing control of yourself, ask friends or parents to come to you and stay with the child;
8. Control how your child is treated by a nanny, grandmother or friend while you are not at home;

If the child constantly cries, sleeps poorly, or suffers from colic, the parents may break loose. Probably, every mother had a moment when she shook the baby in a state of anger and despair. The stress level of some parents (especially those without outside help) can be overwhelming.

Even before the baby is born, it is extremely important for parents to understand basic aspects safe behavior with child. The first pillar is the organization of safe sleep. Second important point It is the avoidance of risky physical manipulations with the child.

Shake Syndrome (Baby Concussion)- an extremely dangerous phenomenon.

What's happening? An adult shakes the child (usually in a fit of anger or irritation) or throws it on the bed. Such a shock can lead to lethal outcome or significant brain damage. The neck muscles of a newborn and infant are not yet so strong, while shaking the head dangles back and forth, rupture of blood vessels, damage to brain tissue, and brain hemorrhage can occur.

Shaking is dangerous for children under five.

The greatest risk to health and life exists before the first year of life. The saddest cases occur before 8 weeks of life: at this time, babies cry a lot.

Normal interaction with the child is safe. It is the strong shaking, the throwing of the child on the surface that is dangerous. Sometimes in a rush negative emotions parents can begin to rock the child very abruptly and strongly: this is also dangerous. The swing should be smooth and soft.

Most child shaking accidents occur when the father is caring for the child, not the mother. For example, a dad was asked to babysit or help put him to bed.

If you are just preparing to become parents, it is important for you to understand the dangers of baby shaking in advance.

If you are on the verge of a breakdown, it is best to put the baby in the crib and leave the room for a while. If you are not yourself, it is better to leave the child to cry than to shake him.

Be sure to ask for help if you have it. But at the same time, make sure that your assistants understand the aspects of safe behavior.

Useful tips can be found in these articles: