The Texas Department of Family and Protective Services, Division of Licensing, is providing the following general information on Shaken Baby Syndrome and SIDS as a public service to visitors of our web site.

Shaken Baby Syndrome

Shaken Baby Syndrome is a term used to describe brain injury in young children under three years of age (most commonly under 18 months) resulting from vigorous shaking of an infant or child by the arms, legs, or shoulders. This motion often results in bleeding inside the head and can cause irreversible brain damage, blindness, cerebral palsy, hearing loss, spinal cord injuries, seizures, learning disabilities, and even death. It can be traced historically from the mid-1500's and was officially named and defined in 1974.

Shaken Baby Syndrome is considered to be a form of child abuse. If you believe that your child has been subjected to any abuse, please report it by calling 1-800-252-5400 if you live in Texas, Oklahoma, Louisiana, Arkansas, or New Mexico. Other states may use 1-512-834-3784 to report abuse or neglect that has occurred in Texas.

Presenting symptoms can be vomiting with lethargy or drowsiness, respiratory difficulties, coma or death. Usually reported is that the infant stopped breathing, went to sleep and could not be aroused, was dropped or rolled off something . Diagnosis is made by CT or MRI scans and eye examinations. Skull fractures are usually not present, rather hemorrhages in the brain.

Parents of children receiving out of home care should discuss all forms of discipline with the caregiver. This discussion should include references to Shaken Baby Syndrome.

Sources -- Children's Trust Fund of Texas; American professional Society on the Abuse of Children. Multiple sources available on the internet under Shaken Baby Syndrome.

Sudden Infant Death Syndrome - Understanding and Action

By Lisa Newsom, Executive Director, North Texas SIDS Alliance

Sudden Infant Death Syndrome, SIDS, remains a leading cause of death for infants in Texas. Metropolitan areas see the largest concentration of deaths; however, all communities are at some time affected by a SIDS death. Knowledge of SIDS facts, learning the steps to take to reduce the risk of SIDS, and implementing a plan of action to deal with the sudden death of an infant will promote a comprehensive community response to SIDS.

Sudden Infant Death Syndrome is the diagnosis given for the sudden death of an infant, 1 month to 1 year of age, that remains unexplained after a complete investigation which will include an autopsy, an examination of the death scene, and a review of the victim's medical and family history. SIDS is a recognized medical disorder. Infants who succumb to the syndrome appear healthy before the incident, even to a physician. At this time there is no strong evidence to suggest that SIDS can be arrested in anyway. The first and only symptom is death. SIDS appears to occur after an infant has been put down for sleep. Victims may have been down for sleep for as little as ten minutes. There are no apparent signs of struggle or suffering. Though SIDS is associated with an infants sleep time, and often occurs in the crib, the event may occur anywhere the infant is sleeping. SIDS events have occurred in infant seats, car seats, strollers, and in the parents' bed.

SIDS can occur at anytime between 1 month of age and 1 year of age however, 91 percent of SIDS deaths occur before the age of 6 months with the highest concentration occurring between 2 months and 4 months of age. SIDS affects all races and socioeconomic groups. Environmental, behavioral, and physical influences may put some infants at greater risk for SIDS and conversely many SIDS victims meet no risk factors.

Risk Factors

  • Mother less than 20 years of age
  • Late or no prenatal care
  • Premature infants
  • Low birth weight infants
  • Drug and alcohol use during pregnancy
  • Smoking (Mothers who smoke during and after pregnancy triple their risk of SIDS.)

The cause of Sudden Infant Death Syndrome remains a medical mystery. At this time a SIDS event is not predictable or preventable. The good news is, there is promising research on the horizon. These new and promising theories may eventually shed some light on why SIDS occurs and hopefully will lead to some real preventive measures in the future.

Years of evaluation have revealed what SIDS is not.

  • SIDS is not hereditary.
  • SIDS is not contagious.
  • SIDS is not caused by immunization.
  • SIDS is not choking.
  • SIDS is not apnea.
  • SIDS is not suffocation.
  • SIDS is not child abuse.

Though there is no prevention at this time, thankfully, there are steps we can take to reduce the risk of SIDS. In 1994, the U. S. Public Health Service and the American Academy of Pediatrics launched a nationwide program to reduce the risk of SIDS called Back to Sleep. The recommendations of Back to Sleep are based on data gathered from other countries, such as England and Australia, which have reduced their SIDS rates by over 50 percent with similar programs.

To Reduce the Risk of SIDS

  • Healthy babies should be placed on the back for sleep.
  • Babies should sleep on a firm flat surface with no soft bedding, pillows, sheepskins, or stuffed toys in the crib.
  • Get prenatal and post natal care.
  • Avoid overheating the baby.
  • Do not smoke while pregnant or allow anyone else to smoke around the baby.
  • Breastfeed if possible.

Though the United States has realized a 38 percent reduction in the SIDS rate since the Back to Sleep program was launched, SIDS still occurs far too often. The recommendations will not save all infants from SIDS even if all parents and caregivers comply. As a result, communities need to educate themselves about SIDS and have a plan of action in place that will provide a thorough and compassionate investigation of the sudden death of an infant. A complete investigation must include an autopsy, death scene investigation, and review of the victim's medical history. The autopsy is essential to a SIDS diagnosis. Counties not in the jurisdiction of a chief medical examiner must plan where to send an infant for examination and have the funds available. All other causes of death cannot be ruled out without performance of an autopsy. To aide communities in their investigation of the death scene, the Centers for Disease Control have compiled a protocol. The protocols are available through the North Texas SIDS Alliance (NTSA) at no charge. Also available through the NTSA, at no charge, are parent information packets.

The unexpected death of an infant for no apparent reason, SIDS devastates families. When professionals are educated and prepared, families affected by SIDS are spared further confusion and pain as their community responds with confidence and compassion.

Texas SIDS Support and Information

  • North Texas SIDS Alliance - 1-800-650-SIDS - DFW, Greater Houston, North, West, and East Texas.
  • SIDS Support for San Antonio-1-800-859-3603 -San Antonio and Austin
  • Parkland SIDS Center - Dallas 214 - 648-2796