SHAKING a baby can be deadly.
Once, a crying baby fell into a coma after being shaken violently. The baby eventually died.
Dr Cheng Tai Kin, a consultant paediatrician at Kinder Clinic in Parkway East Hospital, saw the baby when it was brought to him in a comatose state a few years back.
Dr Cheng, who has seen about a dozen shaken baby syndrome (SBS) cases in his 13 years of practice, said: “We feel sad for the child because the child is innocent.”
He declined to give more details about the case.
In a recent case, 30-year-old father Devagirii was jailed two years for causing the death of his baby through a rash act on June 10 last year.
To stop the child from crying, he had repeatedly rocked her forcefully in his arms for 10 to 15 minutes until she was quiet. She died a week later of bleeding in the brain.
The syndrome occurs when a baby or child is shaken violently, even for as short as five seconds. It affects infants and toddlers under two years old, but may also occur in those up to five years old.
Studies conducted in the United Kingdom and North America revealed that 11 to 17 children in every 100,000 suffer from SBS yearly. Out of that figure, one in four babies with SBS die and over 70 per cent have some form of neurological deficit.
No figures In Singapore, there are no mortality and disability figures for SBS. The Ministry of Health does not track such data here. But KK Women’s and Children’s Hospital (KKH) sees about one to three cases every year, said a KKH spokesman.
Dr Phuah Huan Kee, a paediatric neurologist from Singapore Baby and Child Clinic at Mount Elizabeth Medical Centre, has seen about six to ten cases in his 10 years of practice. Said Dr Peter Wong of the Children’s Emergency at KKH: “SBS does not occur when a parent jogs with a baby in a baby carrier, or tosses an older baby in the air as part of play.”
Violent shaking constitutes holding the baby under the arms and shaking the baby to and fro, without any support to the head or neck.
Dr Chew Su Yah, associate consultant of the Children’s Emergency at the National University Hospital, said: “The longer and more violent the shaking is, the more likely it is that there will be devastating injuries. The force from an angry adult
shouldn’t be underestimated.”
As the space between the brain and the skull in a baby is large, violent shaking will result in the brain ricocheting in the skull.
The vigorous rattling causes brain vessels that hold the brain in place to tear away from the skull, causing bleeding.
Bleeding will then cause blood clots that press on the brain. This will result in fits or brain damage. In severe cases, the baby could die, said Dr Cheng.
But if the baby survives, the child usually suffers from slow mental growth and developmental delay. Blood vessels in the eyes could burst and in severe cases, the baby could become blind.
There are even cases where the baby suffered from fractured ribs due to strong grips on the baby, Dr Cheng said.
Dr Wong said SBS can be treated using “supportive therapy”. This means a ventilator is used to help the baby breathe, and medication for the heart and blood pressure is given.”
He added: “Seizure medications are used to control seizures and protect the brain from further injury. If there is a blood clot in the brain, or bad brain swelling, surgery may be needed.
“Unfortunately, no surgery can reverse injury of brain tissues. And despite the best efforts in the operating theatre and ICU, victims often succumb to their injuries, breaking the parents’ hearts.”
The perpetrators are usually caregivers like “a close relative, stepfather or boyfriend”, Dr Cheng said.
He added: “Out of frustration, the perpetrator shakes the baby until the baby stops crying. But the child stops crying because he or she has suffered brain damage.
“Usually it’s covered up by the family. But with further investigation, you realise that it is child abuse.”
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This article was first published in The New Paper.
