"Shaking a baby is the worst thing to stop crying"

An action of just two or three seconds can have consequences for a lifetime. Shaking a baby to stop crying can lead to blindness, irreversible neurological damage, or even death. The Vall d’Hebron hospital in Barcelona has launched a prevention program against shaken baby syndrome (shaken baby syndrome, in English), a desperate act of parents trying to combat the uncontrolled crying of a newborn, given the increase in these cases. The center has already accounted for five this first semester, double the annual average of the last decade, and links this growth to the emotional and economic impact of the pandemic on the daily lives of families. Health professionals consider that parents are not aware of the traumatic or neurological damage that they can cause to their children.

Shaking is especially harmful to babies. They cause their head to undergo rapid acceleration and deceleration movements for which they are not prepared due to the large size of the skull in proportion to the rest of the body and weak neck musculature. These shakes facilitate serious injuries: the most frequent are cerebral and retinal hemorrhages (of the retina of the eye), bone fractures and neurological sequelae, such as motor impairment or mental retardation. “Shaking a baby is not the most frequent physical violence against children, but it is the one that causes the most deaths and the most consequences,” says Anna Fàbregas, assistant to the hospital’s Pediatric Service. Of the 27 cases detected in the last decade, half were admitted to the ICU and 40% presented cognitive deficit. Two children died from this syndrome. “Shaking is more damaging in the first six months of life,” insists Fàbregas.

The Vall d’Hebron Hospital wants to send a prevention message to parents, especially first-time parents. The nursing team will inform mothers and fathers of the risk of this syndrome at the bedside and a sentence will be included on the medical discharge sheet on the same line. “We have verified the misinformation that exists in this regard,” says César Ruiz, head of the neonatology section.

Doctors point out that shaking occurs at times of great stress, when parents find themselves without the resources to calm a crying baby. Crying, experts explain, is the way babies communicate. Most healthy children who cry are tired, hungry, wet or dirty, or have socio-affective needs, such as wanting to hear a familiar voice or be held. “If their demands are not met, they will continue crying because they do not have the ability to self-regulate,” summarizes Ruiz.

According to the section chief, the first thing to do is to rule out that the baby is sick and from there try to find out what their request is: “Babies are very honest, they stop crying when they get what they ask for”. When the crying is uncontrolled, the parents try to calm him down, although it is not always possible. Ruiz proposes holding him in his arms, going for a walk, looking for the rattle of the stroller or changing the environment to try to recover the baby’s attention in a natural way. If nothing works, it’s worth leaving him in the crib as a last option. “What you should never do is shake him to calm down. It’s the worst”, claims Ruiz again, who admits that it is common for many parents to take their children to a doctor due to continuous crying.

Babies cry for an average of two to three hours a day, but the crying can last longer and continuously. It is in these contexts of lack of control that the risk of parental despair increases. Fàbregas rejects that there is a marked profile of those adults who can fall into the shaking, but admits that it happens more among younger parents with little experience; and in the older ones who suffer from lack of rest. “This syndrome occurs in more vulnerable environments, single-parent families, with economic or couple problems…”, explains the doctor. According to data from Vall d’Hebron, 21 of the 27 cases reviewed affected boys and six affected girls. “If sexual violence tends to affect girls more, physical violence hits boys more,” laments the doctor.

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