A Case of Shaken Baby Syndrome After Discharge From the Newborn Intensive Care Unit

Abstract

Preterm infants may be at higher risk of physical abuse after hospital discharge. Nonaccidental or inflicted head neurotrauma is the most common cause of mortality and morbidity in physical-abuse cases, and shaken baby syndrome (SBS) is the most common form of abuse. In the majority of the cases, parents who shake their infant do not intend to harm the infant. This article presents a report of a former preterm infant who presented to the pediatrician's office with a maternal report of an accidental fall. Shaken baby syndrome was suspected based on bilateral subdural hemorrhages of varying ages, which were inconsistent with the history provided. The differential diagnosis and systematic clinical evaluation for SBS are provided, and medical and nursing management is discussed. Patient care, advocacy, and mandatory reporting are reviewed. The newborn intensive care unit caregivers' role in preventing SBS in this high-risk population, including specific parent teaching and anticipatory guidance, is reviewed with an emphasis on teaching all caregivers about the dangers of shaking an infant.

Resurgence of Infant Caregiving Responses

“…Resurgence would be detrimental with parents who have a history of successfully terminating crying episodes with rough handling. For example, in some cases of fatal infant shaking, perpetrators report that they had shaken the baby previously (Hoffman, 2005). Thus, caregiver responses to inconsolable crying represent one example of the importance of understanding the contribution of behavioral history to resurgence and other extinction-related phenomena.…”

Recommendations for involving the family in developmental care of the NICU baby

“… 19 , 20 This separation may render the preterm baby, especially one who is very low birth weight, to be at risk for abuse and maltreatment following hospital discharge. 17 , 21 , 22 …”

Gua sha research and the language of integrative medicine

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