Shaken Baby Syndrome, the signs to immediately notice about the abused child

Shaken Baby Syndrome, the signs to immediately notice about the abused child


Behavioral changes, breathing difficulties and dilated pupils are just some of the manifestations of shaking syndrome (Shaken baby syndrome – Sbs) which, according to data collected by the Terre des Hommes association, caused fatal injuries in 5 infants between 2018 and 2022 and in another 25 cases, after some time, serious compromises in the developmental path of the boy or girl occurred.


The symptoms, to an inattentive eye, may appear to be those of other pathologies and may be underestimated also because the shaking is not always voluntary, sometimes it is caused by movements that may seem banal such as “piggybacking” on the legs of an adult. Only MRI or CT scans can detect shaking symptoms with certainty. Unfortunately, however, in 40% of the cases taken into consideration by the Terre des Hommes research, these tests were carried out only 24 hours after entering the emergency room, a delay which makes the diagnosis and therefore the correct management of the condition more difficult. victim.

The signals

“It is important to learn to understand the signs of shaking syndrome from small details and intervene immediately because early diagnosis and specific treatment, in cases of greater clinical complexity, can save children’s lives.” The doctor says it Melissa Rosa Rizzottohead of the Regional Center for the diagnosis of abused children of the University Hospital of Padua, the first department in Italy with a dedicated team for the diagnosis and treatment of syndromes of abuse or neglect in children.

“Mistreatment”, continues Rizzotto, “is inclusive of all forms of abuse, from the physical to the psycho-emotional and sexual. Then there is neglect or negligent treatment or commercial exploitation. The absence of of care resulting in actual, potential or developmental damage to the child’s health, survival and development”.

The first crisis unit

The first crisis unit for abused children was established in Padua in 1987 thanks to an experimental project financed by the Veneto Region. Two years later, the world guidelines for the diagnosis and care of abused children were written in Geneva and among the 50 experts who contributed to the drafting of the document there were also professionals from the Padua hospital. The formalization of the regional center for the diagnosis of abused children came in 2000 with the resolution of the Venetian regional council which established it at the Padua hospital.

“We are now a best practice to which many Italian hospitals, pediatric and otherwise, are referring to build similar paths for taking care of victims”, explains Rizzotto, “when the child, for example, is referred from the emergency room to our center we are also able to take care of his family because often behind mistreatment there is parental fragility. We are able to take care of the entire family unit because in addition to the paediatrician, psychologist and nurse, the center can count on an expanded multi-specialist team that involves all departments of the hospital”.

Poor choices made by families have consequences for infants and young children. “We visit young patients who are subjected to food choices made by their parents which, however, are not compatible with their development and therefore suffer damage. Children who are not adequately stimulated and therefore, especially in the first two years of life, risk cognitive deficits because their “The brain does not develop fully. We often find 1 to 4 forms of abuse per child. And deaths in 10% of cases are caused by Shaken Baby Syndrome”, adds the expert.

1600 families with abused children

Since 2008, the year in which the clinical activity began, the Center has taken care of more than 1600 families with children who were abused at home or victims of peer violence, bullying or pedophilia. He carried out more than 260 ordinary hospitalizations, for a total of almost 4,700 days of hospitalization; more than 550 Day Hospital admissions, for a total of approximately 1,200 days of hospitalization. The average is around 30-35 children visited per month and over 300 consultations for other hospitals in the regional and national network. It should be underlined that 30 percent of the consultations provided by the Center are for patients arriving from other Veneto cities and 10 from outside the region.

“From the data we have collected – continues Rizzotto – we can say that 55% of our patients are girls and of the total 1 in 3 receives our diagnosis within 3 years of age. They are children who predominantly present the symptoms of Childhood Syndrome shaken, exposure to narcotics or severe neglect syndrome. I think it is important to note that if you compare two cranial CT scans of two different children of similar age, let’s say around the age of one, who have suffered different violence, for example, the first was shaken and the second poorly nourished, the two CT scans will be similar, that is, they will show similar traumas, often irreversible which can lead to death or disability”.

To inform about the risks of incorrect behavior for the lives of children, Terre des Hommes with Simeup, Anpas, Fimp and the Hospital Network against Child Maltreatment is promoting the first Shaken Baby Syndrome awareness and prevention day on 7 April. Info points will be set up in over 25 Italian cities to raise awareness among citizens.


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