Shaken Baby Syndrome

Medically Reviewed by Jabeen Begum, MD on February 21, 2024
7 min read

Shaken baby syndrome is a serious brain injury that happens to a baby or young child when it’s shaken with force. The impact kills the baby’s brain cells and keeps oxygen from getting to the brain. 

Shaken baby syndrome is a form of child abuse. When a baby is shaken hard by the shoulders, arms, or legs, it can cause learning disabilities, behavior disorders, vision problems or blindness, hearing and speech issues, seizures, cerebral palsy, serious brain injury, and permanent disability. In some cases, it can be fatal.

Shaken baby syndrome is a type of abusive head trauma (AHT). AHT is the No. 1 cause of child abuse deaths in kids under the age of 5 in the U.S., and it causes about one-third of child abuse deaths. Children under the age of 1 are at highest risk. Other forms of abusive head trauma include: 

  • Forcefully throwing or dropping a child on purpose 
  • Hitting the child's head or neck against something, like the floor or a piece of furniture 
  • Hitting the child's head or neck with an object

Shaken baby syndrome is different from gently tossing a baby playfully into the air, bouncing a baby on your knee, or bicycling or jogging with your baby. Though their brains and necks are fragile, babies are also unlikely to get shaken injuries by falling off furniture or making sudden stops in a car. The injuries caused by shaken baby syndrome are also very unlikely to happen if your baby accidentally falls from your arms. 


Being shaken affects babies in many ways. Symptoms include:

  • Vomiting
  • Bluish skin
  • Tremors or shakes 
  • Breathing issues 
  • Drowsiness
  • Less interest in eating
  • Trouble sucking
  • No more smiling or talking
  • Low energy or decreased muscle tone
  • Extreme crankiness
  • Rigidity 
  • Seizures
  • Not being able to lift their head

You may notice bruises on the arms or chest in the places the baby has been grabbed. Other physical signs include:

  • A larger than usual head or forehead 
  • Different-sized pupils 
  • Not being able to focus 
  • Favoring one arm or leg over another
  • A soft spot on the head that appears to be bulging

Babies with shaken baby syndrome may also have symptoms you can't see, such as:

In mild cases, behavior, health, or learning issues show up later on.

Shaken baby syndrome eyes

Shaking a baby can cause bleeding inside the eye, called retinal hemorrhages. The retina might also detach. The jelly-like filling inside the eye, called the vitreous, might also fill with blood. 

Shaken baby syndrome leads to long-term disabilities in about 80% of cases. It causes a traumatic brain injury, specifically what's called a closed-brain injury. Although symptoms of mild injury might go away with time and medical care, others can be long-lasting and can affect your life in different ways. 

Thinking problems can include: 

  • Confusion 
  • Short attention span 
  • Memory problems 
  • Trouble with judgment 
  • Not being able to understand abstract concepts 
  • Not being able to follow directions beyond one or two steps 

Movement problems can include: 

  • Paralysis 
  • Weakness 
  • Tightening and stiffening of muscles (spasticity) 
  • Poor balance and coordination 
  • Tremors 
  • Swallowing problems 

Problems with the senses can include: 

  • Trouble speaking, finding the right words, or understanding speech (aphasia) 
  • Trouble reading and writing 
  • Slow speech 
  • Problems identifying objects and what they do 

Problems with daily life can include: 

  • Trouble dressing, eating, or bathing 
  • Trouble paying bills or handling other tasks
  • Not being able to drive 

Social problems can include: 

  • Trouble making friends 
  • Not understanding social cues 

Physical problems can include: 

  • Fatigue
  • Dizziness
  • Headache 
  • Lack of bowel or bladder control 

Personality issues can include: 

  • Moodiness
  • Short temper
  • Lack of motivation 
  • Anxiety and depression 
  • Inappropriate sexual behavior 

Traumatic brain injuries can sometimes lead to epilepsy, which might show up years later. 

It takes infants awhile to be able to hold their heads up. That’s because their neck muscles start out weak and get stronger as they grow. The same goes for their brains, which need time to develop.

When a baby is shaken, its brain can bounce between the front and back of its skull. This causes it to bleed, bruise, and swell. It only takes a few seconds of aggressive shaking for this to happen.

Risk factors that lead to shaken baby syndrome

Babies bring a lot of joy, but there can also be moments of frustration if you feel like you can’t console their crying. Most caregivers handle those times just fine. But if those feelings boil over, it can cross a line. Certain things can increase your risk of crossing that line, including:

  • Alcohol or substance abuse
  • Unstable family situations
  • Depression

Because shaken baby syndrome can affect so many parts of a child's health, there may be more than one doctor or specialist involved in the diagnosis. Depending on the child's level of injury, the tests may be done in doctor's offices or a pediatric intensive care unit.

To check the brain, doctors may use a CT scan to look for injuries that need attention right away. MRI scans also show doctors detailed areas of the brain.

X-rays of other body parts, like the arms, legs, spine, and skull, show fractures and whether they were created by force or accident. Doctors might also use a full body scan in babies known as a "skeletal survey."

To check for eye injuries and bleeding, an eye specialist may do an eye exam.

Some disorders can mimic the symptoms of shaken baby syndrome. To rule those out, doctors may order blood tests.

Treatment for shaken baby syndrome depends on the injury. Surgery may be needed in an emergency. Some children will need care for the rest of their lives.

Shaken baby syndrome is 100% preventable. It starts with making sure all the baby's caregivers – parents, grandparents, babysitters, nannies, etc. – understand two things:

  1. The dangers of shaking a baby, even for a few seconds
  2. That babies cry a lot at first. The National Center for shaken baby syndrome calls it PURPLE crying:
  • Peak pattern: At 2-3 months old, babies cry the most.
  • Unpredictable: Crying starts and stops without reason.
  • Resistant to soothing: Nothing stops the crying.
  • Pain-like look on face: When babies cry, they look like they're in pain, even if they're not.
  • Long bouts of crying: Babies can cry for hours at a time.
  • Evening crying: Some babies cry more in the afternoon and evening.

Sometimes you can stop the crying by rubbing the baby's back, singing, using “white noise” from an app or the sound of running water, taking a walk, or using a pacifier. Sometimes nothing seems to work. That’s when you especially need to manage your feelings.

Have a plan in place. If you feel pushed beyond your limit, put the baby on their back in a safe place – or inside your home in a car seat with the baby strapped in on the floor (never leave your child alone in the car) – and step away for a moment. Call someone you trust who'll listen to your frustrations. As you talk, check on the baby every 5 or 10 minutes. You could also ask someone to watch your baby for half an hour while you take a walk and collect yourself.

If you notice your caregiver or another parent struggling, be supportive and suggest a safe place they can take the baby when they need a break. Like babies, sometimes parents and caregivers just need to cry and be comforted.

If you suspect someone of shaking a baby, call your local police or the Childhelp National Child Abuse Hotline at 800-4-A-Child (800-422-4453).

Forcibly shaking a baby, even briefly, can cause permanent brain damage. The results of shaken baby syndrome can be serious and long-lasting, and include:

  • Partial or total blindness
  • Delays in development, learning problems, or behavior issues
  • Intellectual disabilities
  • Seizure disorders
  • Cerebral palsy

Most of these complications require lifelong care.

A child with shaken baby syndrome may need help from different types of doctors as they grow up. Those specialists might include: 

  • Neurologists, who treat the brain 
  • Neurosurgeons, who operate on the brain 
  • Ophthalmologists, who treat eye conditions 
  • Endocrinologists, who treat hormone problems 

A child with shaken baby syndrome might also need speech, physical, and occupational therapy. When they reach school age, they may need special education. As adults, they still may need help with daily living activities like getting dressed. 

Survivors and caretakers of those with shaken baby syndrome may be eligible for crime victim assistance programs. 

The National Center on Shaken Baby Syndrome maintains a list of resources for caretakers and survivors of shaken baby syndrome. The list includes:

  • Crime victim assistance groups
  • Disability resources
  • Shaken baby support groups

Researchers who have studied survivors of shaken baby syndrome found that even though they may deal with lifelong disabilities, they can thrive when they receive the right kinds of support. 

Shaken baby syndrome is a type of abusive head trauma. It is the leading cause of child abuse deaths in children younger than 5. It happens when someone forcefully shakes a baby or young child, damaging the brain. It can lead to learning disabilities, vision problems or blindness, and hearing and speech problems. It can cause permanent disability and death. 

Can I accidentally give my child shaken baby syndrome?

The force required to cause shaken baby syndrome makes it very unlikely to happen by accident. You can't cause it by bouncing your baby on your knee or taking them along for a run in a jogging stroller. 

How common is shaken baby syndrome? 

In the U.S., there are about 1,300 cases of shaken baby syndrome each year.