Diagnosis of Shaken Baby Syndrome

Shaken baby syndrome is difficult to diagnose, unless someone accurately describes what happens.  Physicians often report that a child with possible shaken baby syndrome is brought for medical attention due to falls, difficulty breathing, seizures, vomiting, altered consciousness or choking. 

The caregiver may report that the child was shaken to try to resuscitate it.  Babies with severe or lethal shaken baby syndrome are typically brought to the hospital unconscious with a closed head injury.

To diagnose shaken baby syndrome, physicians look for retinal hemorrhages (bleeding in the retina of the eyes), subdural hematoma (blood in the brain) and increased head size indicating excessive accumulation of fluid in the tissues of the brain. 

Damage to the spinal cord and broken ribs from grasping the baby too hard are other signs of shaken baby syndrome.  Computed tomography (CT) and magnetic resonance imaging (MRI) scans can assist in showing injuries in the brain, but are not regularly used because of their expense. 

A milder form of this syndrome can also be observed and may be missed or misdiagnosed.  Subtle symptoms which may be the result of shaken baby syndrome are often attributed to mild viral illnesses, feeding dysfunction or infant colic.  These include a history of poor feeding, vomiting or flu-like symptoms with no accompanying fever or diarrhea, lethargy and irritability over a period of time. 

Often the visit to the medical facility does not occur immediately after the initial injury.  Without early medical intervention, the child may be at risk for further damage or even death, depending on the continued occurrences of shaking.