Why you can't shake the baby. Recommendations for the prevention of shaken baby syndrome. WHAT is Concussion Infant Syndrome

26.04.2019

Many parents, noticing frequent and small twitching of the lips, chin in a newborn baby, lower jaw, arms or legs, people often wonder if these twitching (tremors) can be considered normal. Tremor Is a compensatory reaction of the baby's immature nerve fibers in the form of small muscle cramps that occur to stabilize the condition nervous system... It can be physiological and pathological.

Physiological tremor small in amplitude, it is rhythmic and often occurs when a child is crying. With tremors in newborns, tremors are more common underlip or chin, and in rare cases, arms or legs. Tremors can be asymmetrical and symmetrical. For example, one handle may shake or both.

Distinctive features physiological tremors are:
1. Its rapid disappearance (after a few seconds);
2. Appearance after nervous tension(bathing in the bathroom, intestinal colic, crying, changing clothes, 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 rare. Tremor symptoms are especially pronounced in premature babies because their nervous system is more immature than in 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 the twitching process involves not only the lips, chin and limbs of the baby, but also the head.

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

This condition of the child should alert the 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 reason for the appearance of tremors of the lips, chin, upper and lower limbs in a newborn child, there is immaturity of some nerve centers of the brain and a high content in the blood serum of the adrenal hormone - norepinephrine, which is responsible for the transmission of nerve impulses. Physiological tremor is observed in the majority (about half) of newborns up to 1 month old and in almost all premature babies.

The main predisposing factors for the underdevelopment of the baby's nervous system are: oxygen starvation and an excessive 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;
entanglement with an umbilical cord;
trauma during childbirth.

Treatment

Physiological tremor the child does not need medication. Neurologists recommend that the parents of the baby carefully observe the baby to find out those 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 establishing 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 and the mother of the baby. Nice results give swimming lessons, as well as creating a friendly and calm atmosphere in the family.

Massage for tremors in a newborn

Massage for tremors in a newborn is recommended to start from 5-6 weeks of life. It is relaxing and restorative and helps to strengthen the baby's nervous system. The massage should be performed by an experienced massage therapist; later, the mother of the child can also learn the techniques of massage.

Recommendations for massage for tremors in a newborn:
1. Ventilate the room before the session.
2. Hands should be clean, warm and dry, nails cut short.
3. The session should be carried out during the period 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. The massage must be stopped if the child is crying or somehow shows his displeasure.
7. Do not use for massage aroma oils or baby powder (you can use a baby's usual cream).

The following movements can be used for a relaxing massage:

stroking;
kneading;
trituration;
vibration.

Each newborn massage session should begin and end with stroking. All movements should be smooth and pleasant for the baby. The movement should be directed along the joints (from the periphery to the center or from the bottom up). The force of pressure is determined by a specialist and, in the event that the mother of the child will also carry out the massage, 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 hand), and the right hand strokes (10 times), gentle rubbing of each finger is performed, then the other handle is massaged;
chest massage - the palms of the hands are placed on the base of the neck and stroking downward ("herringbone"), repeat 6-7 times;
tummy massage - palm right hand put on the baby's belly and do circular motion clockwise, perform about 10 times;
foot massage - performed in the same way as hand massage;
back massage - the baby, holding the handle and leg, is turned over onto 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, 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

How many parents know what the Syndrome is? baby concussion? We will tell you why you cannot shake the child, why you cannot throw the child or throw him on the bed. The fact is that all these actions can lead to grave consequences, even lethal!

Concussion infantile syndrome (CHS) is also known as post-concussion syndrome, concussion syndrome, concussion syndrome, and shaken child syndrome. All of these names mean one thing: the resulting brain damage.

Concussion infantile syndrome (CHS) can result from blows to the head, tossing or dropping a toddler, or violent shaking.

SDS is one of the leading causes of infant death in the United States. Due to its special anatomy, the infant is susceptible to great risk from the listed actions, therefore the majority of victims are children under one year old.

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

Injury methods

Concussion syndrome is caused by an injury caused by someone (most often a parent or caregiver). The reason is 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 may stop abruptly, because the brain has been damaged.

If there are several children in the family, children with special needs, colic or GERD, their chances of 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 experience both SDF and other types of childhood trauma from parental abuse.

In 70% of cases, male representatives are guilty of child injuries- fathers or stepfathers, often young age... But anyone who is unable to cope with emotions and overcome anger, and who is also prone to using force, can resort to vigorous shaking of the child in order to calm him down. Alcohol abuse is also a common cause of SDS.

When a person shakes a toddler violently, the unsecured 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 hemorrhage under the lining of the brain.

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

Habitual play with children, light throwing or tossing of a child on his knee does NOT lead to this injury. But you can not, under any circumstances, SHAKE the child.

Concussion Infant Syndrome: Implications

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

The consequences can be:

complete or partial blindness;
hearing loss;
epilepsy;
delay in mental development;
speech disorders and learning problems;
problems with memory and attention;
serious mental retardation;
paralysis.

Even if, after a strong shaking, the child looks absolutely normal outwardly, after a while one of the symptoms may all the same manifest. Most often, the problem occurs without any external signs of damage, and problems with behavior, memory or learning become evident only during the period when baby goes to school.

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

Concussion baby syndrome: symptoms

Each case of SDS depends on the severity and duration of exposure, the frequency of use of force, and possible other forms of violence. In the most horrific cases, children are admitted to the trauma 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 examined.

Concussion syndrome, symptoms that should alert you:

lethargy;
irritability;
vomit;
inability to swallow;
decreased appetite;
Bad mood and quiet behavior;
rigidity;
seizures;
breathing disorder;
blue discoloration due to lack of oxygen;
loss of consciousness;
unequal pupil sizes;
unable to raise your head;
inability to focus or move.

Concussion Infant Syndrome: Diagnosis

Most of the cases, the consequences of DFS are considered as "causeless trauma". In other words, parents and caregivers often fail to associate concussion syndrome with injury or shaking, so doctors cannot diagnose the disease right away.

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

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

If doctors suspect SDS, the signs are:

retinal hemorrhage;
damage to the skull;
swelling of the brain;
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.

Developing and teaching a child with concussion syndrome

The reason SDS is so serious and destructive is that it often causes generalized traumatic brain injury. For example, a child who has a seriously impaired vision will not be able to use his eyesight when studying the world around him, therefore, the child's general ability to learn is sharply reduced.

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 develop normally if they did not have a traumatic brain injury.

As they grow up, these children may need both constant language and general therapy to help with the simplest daily tasks.

How to prevent concussion syndromes

The chances of preventing concussion syndrome are one hundred percent. The basis for this is public awareness of the potential threat of shaking a child.

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

The National Program All Children Cry in the United States informs the population about ways to overcome parental anger and irritation during child crying and promotes healthy parenting children. There are four categories in the program:

P-position lying or on its side:(position on the left side - to help the child digest food, on the stomach - while the parent is holding the child, on the back - sleep)

C-nipple: breastfeeding, bottle, nipple or finger

P- : a child wrapped in a blanket like a burrito will help him feel safe. The hips and legs may be on the outside or slightly covered.

K-swing : Slightly rocking in a chair, in a crib, or driving a car can help a child feel similar vibrations they experienced in their belly.

If the baby keeps crying

If the baby continues to cry, try the following:

make sure that the baby is full and does not need to change the diaper;
check or the child is not sick;
shake or scold the child in your arms;
speak or sing to the child;
give your baby a pacifier or toy;
give your child a ride in a stroller or safety child seat in car;
hold the baby close to you and breathe slowly and calmly;
buy in a warm bathroom;
stroke the back of the child;
ask someone to help you take a break and look after your child;
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.

Parents and caregivers need to learn to prevent SDS. It is important that the caregiver is aware of the dangers and consequences of childhood injuries not to be shaken under any circumstances.

Shaken Baby Syndrome - Symptoms:

Headache
Increased excitability
Drowsiness
Decreased appetite
Decreased muscle tone
Vomit
Convulsions
Loss of consciousness
Breathing disorders
Increase in head circumference (in children up to 4 months)

Consequences of Concussion Infant Syndrome:

Mental retardation
Blindness
Paralysis
Epilepsy
Fatal outcome

Why does SDS occur?

Most cases of Concussion Child Syndrome do not occur in families of alcoholics, drug addicts and other disadvantaged social elements. More often than not, children fall prey to shaken baby syndrome in absolutely normal families, when loving parents at some point they get annoyed, angry with the child and in despair shake him or throw him abruptly into the crib. According to statistics, this behavior is more typical for fathers and stepfathers than for mothers or nannies.

In 2003, the first concussion syndrome trial took place in Switzerland. The accused of the manslaughter of his son was the famous climber Erhard Loretan, who was left alone with his seven-month-old baby on Christmas Eve. The child did not want to fall asleep, cried for a long time and, having lost patience, Erhard took him firmly with both hands and shook him slightly. The child calmed down and fell asleep, Erhard put him in the crib, and in the morning noticed that his son was unconscious. A day later, the child died in the hospital. The father was sentenced to a suspended sentence and a fine.

Emotional breakdowns of parents or guardians are not the only reason SDS. Often, shaken baby syndrome can occur when the baby is carelessly treated during games, when the baby is thrown into the air, in transport accidents or when the baby falls. The latter is especially true for newborns who, through negligence, are left unattended, even for a short time.

Measures to prevent VTS

In order to protect the child as much as possible from unintentional harm to him, pediatricians and child psychologists recommend observing the following rules:

Do not leave children (especially newborns) unattended in unsafe places: on beds without sides, changing tables and other elevations. Even a few seconds of your absence can cost your child health or life.
When in the car, use age-appropriate car seats for your child. Be sure to fasten your baby with seat belts.
Never, under any circumstances, shake a child under the age of two.
Do not toss children up.
Hold the head when handling a newborn
Try not to get discouraged if your child is hysterical. He's not crying because he's testing you, or because he's bullied. Crying for a child is the only way let you know about your concerns. In addition, if an adult, being near a child, begins to lose control over his emotions, the child feels it. The baby begins to perceive you as a threat to his safety and cries even more from fear.
If there is no way you can calm crying baby, get annoyed and lose control - gently place your baby in a safe place, for example, in a crib, and leave the room for a few minutes. Calm down, take a breath and return to the child. Crying alone for a few minutes will not hurt your baby, but it will give you a chance to recover.
Try to involve other family members or people you trust as much as possible in caring for your child. This will help you avoid fatigue and nervous breakdowns... If this is not possible, simple human communication may help you, or favorite hobby... Walk with other moms, call friends, knit, collect airplane models in your spare time. Do whatever helps you relax and unwind.
Satisfy the natural needs of the body. You have not slept enough, you are hungry, you have not been in the bathroom or toilet for a long time - all these factors provoke instability of the emotional state.

The main cause of parental irritation is children's crying, however, adults can lose self-control if the child refuses to eat, does not want to sit on the potty, hesitates and is naughty at a time when you need to quickly get ready somewhere, etc. In all similar situations always remember that even a slight shake little child can lead to irreversible consequences. Remember that your baby is unable to control his emotions, so adults are solely responsible for the emotional climate in your family. Children will very quickly outgrow the period of crying and tantrums and it is important to help them do this as safely as possible.

We are very scared when a child falls over due to an oversight of a young mother. We do not understand and get angry when we see when they beat and shout at children.

It is generally accepted that only bad parent will cause physical violence to his child. We, as good parents, will never physically harm our beloved child. And in general, physical violence is a lot dysfunctional families! Although slaps on the buttocks are also common in prosperous families ...

Can good parent harm, physical violence to your child, without knowing it? My answer is maybe. Unknowingly ... although ignorance of the laws does not absolve from responsibility.

In this article I want to tell you about such a "law". Not only injury and bodily harm is physical abuse. One of the manifestations of physical violence against the smallest (children from 0 to 3 years old) is the shaking baby syndrome.

Let me give you an example. The child cries all night, the young mother is no longer strong, her nerves are at the limit. Out of anger, she pulls with all her strength on the bed in which the baby is crying. It seems that the child has become quiet, and the anger has subsided, it seems that everything is fine.

Shake Infant Syndrome includes trauma that a parent or other adult can cause crying baby to calm him down.

Situations that cause the formation of the syndrome

Situations can be as follows:

Intense motion sickness in a rocking bed, on hands, in a wheelchair. Dear Parents, this does not mean that you cannot rock the baby in your arms. Your actions should be soft, smooth, gentle.
Throwing the baby up (questionable point for many experts). In my opinion, this action is especially dangerous in the first three years. But even after three years, this action is not safe for the baby.
Throwing the baby onto objects or onto the crib.
Shaking hand, shoulder, chest, legs.
Strong slap on the buttocks or back.
Shaking to wake up.

When a child cries, an irritated adult by such actions gives out anger and anger. As a rule, the most often shaken women are women, with postpartum depression... Although, according to some sources, dangerous acts are performed by men. But mothers, and fathers, and grandparents, aunts and uncles should know:

Small children should not be shaken or shaken violently. These actions can damage the brain and spine. The ease of injury can be explained by the fact that the baby, his bones, skull, spine have not yet formed, they have a soft structure.

Since the baby's muscles are not sufficiently developed, or rather the muscles of the neck, sharp movements heads can damage the brain (hemorrhage in the brain or retina can occur).

Other consequences of shaking syndrome include:

fractures
convulsions
blindness
delayed emotional and physical development
learning and behavioral difficulties.

Tips for Preventing Shaken Infant Syndrome

Find out how you can calm the baby (you must find the reason that worries the little one). Pediatricians do not recommend rocking a child so that he stops crying.
If you yourself or someone else accidentally or deliberately shook the child, then you urgently need to see a doctor.
If you are tired, irritated, feel outbursts of anger, filled with negative emotions and worries, ask someone from your family to be with the child. If support is not available, leave the baby in safe place(crib) for 5-10 minutes. During this time, you will come to a normal state.
Take care of your personal time. To maintain psychological balance, devote some time to yourself or your friends (go to the movies).
Do not blame yourself for any negative emotions you may experience with your child. These emotions are normal. The main thing is that they do not cause harm to the baby.

The most important thing is to be neat and gentle with the baby, because he is completely defenseless.