Chapter 3: Health Promotion and Protection
3.4 Health Protection in Child Care
3.4.4 Child Abuse and Neglect
220.127.116.11: Preventing and Identifying Shaken Baby Syndrome/Abusive Head Trauma
All childcare facilities should have a policy and procedure to identify and prevent shaken baby syndrome/abusive head trauma. All caregivers/teachers who are in direct contact with children, including substitute caregivers/teachers and volunteers, should receive training on preventing shaken baby syndrome/abusive head trauma; recognizing potential signs and symptoms of shaken baby syndrome/abusive head trauma; creating strategies for coping with a crying, fussing, or distraught child; and understanding the development and vulnerabilities of the brain in infancy and early childhood.
Shaken baby syndrome/abusive head trauma is the occurrence of brain injury in newborns, infants, and children younger than 3 years caused by shaking a child. Even mild shaking can result in serious, permanent brain damage or death. The brain of the young child may bounce inside of the skull, resulting in brain damage, hemorrhaging, blindness, or other serious injuries or death. There have been several reported incidents in child care (1).
Caregivers/teachers care for young children who may be fussy or constantly crying. It is important for caregivers/teachers to be educated about the risks of shaking and provided with strategies to cope if they are frustrated (2). Many states have passed legislation requiring education and training for caregivers/teachers. Caregivers/teachers should check their individual state’s specific requirements (3). Staff should be knowledgeable about and be able to recognize the signs and symptoms of shaken baby syndrome/abusive head trauma in children in their care.
Victims of shaken baby syndrome/abusive head trauma may exhibit one or more of the following symptoms (4):
- Trouble staying awake
- Trouble breathing
- Unable to be woken up
For more information and resources on shaken baby syndrome/abusive head trauma, contact the National Center on Shaken Baby Syndrome at www.dontshake.org.
TYPE OF FACILITYCenter, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS18.104.22.168 Recognizing and Reporting Suspected Child Abuse, Neglect, and Exploitation
Araki T, Yokota H, Morita A. Pediatric traumatic brain injury: characteristic features, diagnosis, and management. Neurol Med Chir (Tokyo). 2017;57(2):82–93
Fortson BL, Klevens J, Merrick MT, Gilbert LK, Alexander SP. Preventing Child Abuse and Neglect: A Technical Package for Policy, Norm, and Programmatic Activities. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention; 2016. https://www.cdc.gov/violenceprevention/pdf/CAN-Prevention-Technical-Package.pdf. Accessed January 11, 2018
Child Care Aware. Health and safety training. http://childcareaware.org/providers/training-essentials/health-and-safety-training. Accessed January 11, 2018
American Academy of Pediatrics. Abusive head trauma: how to protect your baby. HeathyChildren.org Web site. https://www.healthychildren.org/English/safety-prevention/at-home/Pages/Abusive-Head-Trauma-Shaken-Baby-Syndrome.aspx. Updated November 21, 2015. Accessed January 11, 2018
Content in the STANDARD was modified on 05/30/2018.