(1) Shaken baby syndrome occurs frequently when a frustrated caregiver loses control because of an inconsolable crying baby.

(2) A baby's head is large and heavy in proportion to the baby's body. There is space between the brain and skull to allow for growth and development. The baby's neck muscles are not yet developed.

(3) When an infant or young toddler, usually under two years of age, is shaken, the brain rebounds against the skull, causing bruising of the brain, swelling, pressure and bleeding (intracerebral hemorrhage). This can easily lead to permanent, severe brain damage or death. Shaking an infant or small child may also cause injuries to the neck and spine. Retinal hemorrhages may result in loss of vision.

(4) More than 1,000,000 children are severely abused annually, and shaken baby syndrome is a leading cause of morbidity and mortality in infants.

(5) In the United States, the annual incidence rate of shaken baby syndrome is between 750 and 3,750.

(6) One-third of the victims of shaken baby syndrome survive with few or no consequences, one-third of the victims suffer permanent injury and one-third of the victims die.

(7) Approximately 20% of cases are fatal in the first few days after injury. Survivors may suffer handicaps ranging from mild, including learning disorders, mental retardation, seizure disorders, developmental delays and behavioral changes, to moderate and severe, including profound mental and developmental retardation, paralysis, blindness, inability to eat or permanent vegetative state.

(8) Parental behaviors, environmental factors and child characteristics all may contribute to a shaking event.

(9) Merely telling caregivers not to shake their babies does not go far enough. A plan of action or other recommendations to help caregivers deal with a potentially volatile situation must be offered.

(10) Parents and other caregivers need assurance that allowing a baby to cry is acceptable if all of the child's needs have been met. The caregiver should address his or her stress level and attempt to engage in stress management techniques.

(11) Shaken baby syndrome is preventable. Parents should share the message of the dangers of shaking with all who care for their infant or child, including spouses, their own parents, siblings, day-care providers and others. Parents need to inform those who are caring for their child that it is appropriate to call for help when they feel out of control.