Symptoms:

The symptoms can vary from mild to severe. They may include:

• Convulsions (seizures)
• Decreased alertness
• Extreme irritability or other changes in behavior
• Lethargy, sleepiness, not smiling
• Loss of consciousness
• Loss of vision
• No breathing
• Pale or bluish skin
• Poor feeding, lack of appetite
• Vomiting

There may not be any physical signs of injury, such as bruising, bleeding, or swelling. In some cases, the condition can be difficult to diagnose and may not be identified during an office visit. However, rib fractures are common and can be seen on x-ray.

An eye doctor may find bleeding behind the baby's eye or retinal detachment. There are, however, other causes of bleeding behind the eye and they should be ruled out before diagnosing shaken baby syndrome. Other factors must be considered.