Abusive head trauma

Abusive head trauma refers to head, neck or brain injury that happens when someone shakes or hits a baby on purpose.

It’s very easy to hurt a baby. It only takes 1 or 2 hard shakes to seriously hurt a baby. Shaken baby syndrome is a type of abusive head trauma.

Babies have large and heavy heads compared to their bodies, and their necks are fairly weak. They can’t control their head movement as easily as older children or adults. If you shake a baby, their head will move backward and forward very quickly.This action can shake the brain and is very dangerous.

Rough play, such as tossing your baby in the air or onto a soft bed, can be just as dangerous as shaking them in anger or frustration.

No parent or other caregiver should ever shake a baby.

Many parents and caregivers experience exhaustion and frustration.

At times, you might be tempted to shake your crying baby, especially if the crying never seems to stop. It's important to remember that shaking your baby can cause serious damage to your baby's brain.

If caring for your baby is making you feel overwhelmed and highly stressed and you think you're in danger of shaking your baby, or a baby in your care, here's what to do:

1. Put the baby in a safe place, such as a cot.
2. Walk out of hearing range for a while.
3. Calm down.
4. Ask for help.

Ask family and friends for help, and to give you a break. Talking about how you feel with someone you trust may help you feel less stressed.

It might help to talk to your local nurse or doctor or contact Pregnancy Birth and Baby on 1800 882 436 — they are available for advice and support 7 days a week.

Crying is a normal behaviour in young infants. Babies often cry a lot in the first weeks of life, especially around 6 to 8 weeks of age. It is normal for your 6- to 8-week-old baby to cry on average for 2 to 3 hours per day. Babies usually cry less by the time they are around 3 to 4 months of age.

Sometimes crying can be a sign that something is wrong. If your baby suddenly starts crying and seems irritable, there might be a health problem. They may have an injury or illness that you can't see (for example, a hernia or ear infection) or another health problem.

If your baby suddenly starts to cry a lot for no clear reason and cannot be settled, see your doctor immediately.

There are a few things you can try if your baby won't stop crying.

First, check if the crying is due to something straightforward:

• Is your baby hungry or thirsty?
• Does your baby need a nappy change?
• Does your baby have a fever?
• Is your baby teething?
• Is your baby overtired?

If there is no clear cause and the crying continues, try to calm your baby by: 

• cuddling them 
• massaging them 
• rocking them in a pram
• talking or singing while holding them close

If you can, ask others to help you. This might be: 

• your partner
• your family
• a friend
• a trusted neighbour

Tips to settle a crying baby - video

It can be very hard to know if a baby has a head injury caused by abusive head trauma.

The signs may include:

• drowsiness
• tremors
• difficulty breathing or feeding
• vomiting
• pale or blue-coloured skin

The injury can be life-threatening and the baby is at risk of permanent brain damage.

Even a couple of rough shakes can make your baby's brain hit the hard bone inside their skull, causing bleeding and injury.

Shaken babies can have brain-related problems including:

• blindness
• deafness
• seizures
• difficulty eating or swallowing
• learning, behavioural and speech difficulties

If the shaking is severe enough, the baby might die.

For more information about the symptoms, diagnosis and long-term effects of abusive head trauma see the Sydney Children's Hospitals Network website.

For more information about normal crying in babies and how to settle a crying baby see the Sydney Children's Hospitals Network website.