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Q:  I have a three months old baby boy. I accidentally scolded him once and threw him on the bed because he was crying non stop. He suffered fever three days after that and the fever lasted for only a day. During and after the fever he did not have appettite to drink at all. He cried his lungs out but doesn’t drink. He started drinking only 3 days after the fever ended. Should I be worried about this as I have read about Shaken Baby Syndrome (SBS). 

Secondly, is it normal for my baby to sleep most of the time. He is always sleepy and cranky. Whenever he woke up, he will be awake for an hour and then he will start being cranky because he is sleepy and want to sleep. Is this normal for 3.5 months old baby? I am quite worried at the moment. Highly appreciate your reply. Thank you. (M)

A: Dear M, thank you for bringing this incident to our attention. We have some information to share with you that will be able to answer your questions.

Firstly, you said that your child was not able to feed (drink) for 3 days. That is not normal at all, and should be brought to see a doctor. Poor feeding is a serious sign of illness and should be given urgent medical attention. Being cranky and and being more sleepy than usual are also not normal. In fact, I am worried that these abnormal features that you see in the baby may be a result of head injury.

It was apparent that you became very stressed when your baby was crying without stopping. Indeed whenever a baby cries like that, it is very stressful and even well-meaning parents gets very upset and tensed over this and may end up being too rough with the baby like shaking the baby violently, or throwing to the bed.

Let’s discuss what can go wrong when a baby is shaken violently.

The brain of the baby bounces back and forth against the skull, causing severe injury to the brain which includes swelling and bleeding. Accumulation of bleeding and brain swelling can lead to dangerously high pressure in the brain which can cause death without medical and surgical treatment. This is known as shaken baby syndrome.

A baby is so easily hurt from a violent shaking because of the relatively heavier head ( accounting for 25 percent of the body weight). They also have weaker neck muscles and the veins in the brain are more delicate and prone to rupture and thus bleeding. Furthermore, a developing brain when damaged will lead to catastrophic long term problems.

braininjurygroupfoundation.sharepoint.com

braininjurygroupfoundation.sharepoint.com

If the baby survive this, there will be long term consequences which includes permanent disability being bed-bound or wheelchair bound, blindness, hearing impairment,  mental retardation and also likely to have recurrent seizures.

This showed that a baby can be fatally injured when you behave violently to the baby at the height of your frustration with his crying. In fact, this is tantamount to child abuse. It is unfortunate that statistics showed that most people responsible for causing shaken baby syndrome are parents themselves.

Therefore it is very important that we are aware of this and also to be very familiar with coping strategies when faced with such frustration.

We all need coping strategies, even those with lots of patience. The following are what you should do when you cannot seem to stop your baby from crying :-

  1. Calm yourself down
  2. Don’t blame yourself. Recognise that it is not your fault or the baby’s fault
  3. Put the baby in crib, make sure she is safe and walk away for a short while
  4. Call a friend, relative, parent for support 
  5. Dont jump to conclusion that you are not a good parent. You have to understand that babies do cry, and they cry all the time. 

Babies cry all the time 

Crying is a normal developmental behavior for babies and this includes prolonged bouts of crying. Most babies who cry a great deal are healthy. Studies have shown that  there will be increased crying around the age of 2 -3 weeks, it will be the most frequent at the peak age of 6 – 8 weeks and then taper off after 4 months.

Why do babies cry ? 

Crying is the ONLY way they can communicate !They would cry when:-

  1.  hungry
  2.  needs to burp
  3.  wants to suck (on a pacifier or a clean finger)
  4.  needs a diaper change
  5.  feeling too hot or too cold
  6.  getting sick and is cranky
  7.  has diaper rash
  8.  teething
  9.  tired
  10.  over-stimulated

Do not blame yourself that the baby is crying so much. It is likely that it is not because you are doing a bad job but actually normal babies cry like that.  Have you heard of the term PURPLE crying ?

P – crying Peak at 2 months

U – Unpredictable, suddenly crying for no apparent reason

R – Resistant to soothing, cannot console

P – Pain like look in the face

L – Long bouts of cough, crying for hours

E – crying more in the Evening

Even normal healthy babies can cry in a manner as mentioned above.

What to do if a baby cry ?

  • Reassure yourself that you are not a bad parent
  • Gently rub his/her back
  • Gently rocking
  • Offering a pacifier
  • Singing, talking to him/her
  • Taking a walk on a stroller, go for a drive

It is however, very important to make sure that the baby is not ill or injured. Make sure you have done the following:-

  • Check for signs of illness
  • Check fo diaper rash, tight clothing
  • Check if the baby is hungry, or needs to be burped
  • Consult a doctor if you suspect baby is ill or injured

In conclusion, it is important to have a coping strategy when your baby is crying endlessly and seems not consolable. Do not succumb to your own frustration and end up behaving violently to your baby. Although it is unintentional it can lead to severe injury to your baby. I hope this article has given you a new perspective on ways to handle this situation. All the best.

( answered by Dr Foo Chee Hoe )

 

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