Shaken baby syndrome: identification, intervention, and prevention.

More than 1 million children are severely abused annually. Shaken baby syndrome (SBS), one example of physical abuse, is a leading cause of morbidity and mortality in infants. There is a national annual incidence in the United States of 750 to 3,750 cases of SBS. Shaken baby syndrome is defined as vigorous manual shaking of an infant who is being held by the extremities or shoulders, leading to whiplash-induced intracranial and intraocular bleeding with no external signs of head trauma. Shaken baby syndrome should be suspected in infants with a wide spectrum of clinical signs and symptoms. The classic findings of SBS are retinal hemorrhages, usually bilateral, and intracranial injury. One third of the victims of SBS survive with few or no sequelae, one third suffer permanent injury, and one third die. Parental behaviors, environmental factors, and child characteristics all may contribute to a shaking event. The nurse practitioner, in a wide variety of clinical settings, is in a strategic position for the early identification and intervention for families at risk for SBS. Prevention through parent, caregiver, and community-wide education programs is the only option for infants who are at risk for SBS.