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Shaken Baby Syndrome

Babysitter Commentary


1C. Babysitters and Shaken Baby Syndrome

Although there is no way to assure safety for any child, there are some reasonable steps that parents can take to reduce the likelihood of a child’s SBS injury at the hands of a babysitter. We know that babysitters do not comprise the largest group of people who shake and injure or kill babies, however this population does account for a percentage of the cases.

Likely question:

What percentage are babysitters? In a Utah study, "death by babysitter" comprised 17% of the cases. Most perpetrators are men (In Utah, 79%), conversely, most babysitters are women.

2C. Who Will Be Taking Care of Your Baby?

Some babysitters care for your child while caring for their own. A caregiver cannot reasonably attend to more than two children under the age of two years safely.

Sometimes the caregivers’ children are allowed to play with babies who are being cared for. Sometimes their children are rough, and some are not well supervised. Sometimes the babysitter will leave a sleeping baby in the temporary care of their own 10-12 year-old children while they run to the store. These children may decide to wake the baby, play with him, then shake the baby to stop it from crying. Rarely, caregivers leave their charges in the temporary care of their boyfriends or spouses. These individuals, however, may not know what to do, may be irritated if your child cries, then shake your baby in an outburst of temper.

3C. If your Babysitter is a Teenager

4C. If your Babysitter is a Teenager, continued...

Some babysitter are old enough to care for children, but are not mature. The reverse may be true. A parent should always be aware of local regulations concerning age requirements for babysitting, and then check whether the prospective babysitter is mature enough to care for their child.

It is critical that the babysitter know and understand the limitations of babies and children. Expecting a baby or young child to understand commands, expecting children to hold back tears, etc. is unrealistic. The babysitter also needs to know that the environment must be kept safe for children.

School supplies, blow-dryers, cigarettes (does the babysitter smoke?), etc. must be kept out of childrens’ reach.

If the babysitter is doing poorly at school, it may be a warning sign of other problems.

The babysitter’s friends may be a concern...if they are "troublemakers", or "get each other going", they should not be present when the babysitter is working. What will the babysitter do if they come to visit? Is the babysitter assertive enough to make them leave?

Is the babysitter "rough" with siblings? The amount of physical "rough-housing" experienced at home might not be appropriate to use with other children.

Discipline used within the babysitter’s home will often be used by the babysitter with other children. Parents need to be very clear about what disciplines are acceptable and allowed with their children.

The babysitter must be instructed to contact the parent if she or he experiences any problems that can’t be very easily solved. This needs to be emphasized each and every time.

5C. Important Things to Know About Your Babysitter

These questions are hard to ask, and more difficult to get honest answer about. They are, however, important questions. A babysitter who has a "few drinks" to relax - or has a hangover - can be very short tempered or be too impaired to care for a child safely. If the sitter takes medication for a medical condition, it is possible that side effects can affect their performance. If your babysitter has problems with her own children, it doesn’t mean that she won’t be fine with yours, however her attention will be divided, and if her child gets in trouble, your child might go without attention. "Fighting with neighbors" requires inquiry concerning the type of arguments, who is involved, and if there is risk of physical confrontation.

Where domestic violence is present, find another sitter. This is a highly volatile situation and it can become dangerous without warning.

6C. Babysitter History

If your babysitter has ever been in trouble with the police, get the details. The problem may be entirely in the past, however, the problem may be ongoing. If there were reports to CPS, try to find out the circumstances, whether the allegations were substantiated or not and if the situation is resolved.

If your babysitter is certified by an agency, ask the agency how frequently they visit, whether there are unannounced visits, and whether there have been complaints against her. You can always visit the babysitter unannounced, and you should plan to do it.

Asking what type of discipline your baby sitter experienced in her childhood is helpful -- there is a possibility that the sitter may return to using what she experienced if she gets frustrated. This is a good time to remind her specifically about not shaking the baby under any circumstances. 

7C. What Are Your Babysitter’s Expectations?

These common expectations are the source of considerable aggravation to babysitters. Parents’ routines - or lack of routine - and babysitters’ expectations are often in conflict. For example, issues around the baby’s refusing unsweetened food, or not going for a nap at 1 p.m. - when the sitter wants to watch her favorite TV show, or clean her house can be problematic. If her own children were easy to please, and your child is fussy--or if her children were docile and yours is a "little fire-ball" - there is potential for problems. The key is if the sitter is flexible, mature, relaxed and able to change her expectations to accommodate your child’s needs.

8C. Have You Checked On This?

It is essential to know where your child will sleep, eat and play. This is a safety issue. See for yourself. Talking to other parents and checking out ALL other references, can be an eye-opener. Ask: How long did they use her as a sitter; why they aren’t doing so now; what they liked best about her; what they liked least about her.

In the meantime, ask the babysitter what she likes about the work, and what she likes least. And what frustrates her the most. And, ask her how she handles the frustrating parts of the job.

9C. Babysitter Attitudes

Of these questions, one of the most accurate indicators of whether the sitter likes your child is "does your babysitter speak about your child with pride and pleasure". Like a teacher speaks about a star student.

10C. Babysitter Behavior

This is about maturity, good judgment and positive thinking.

11C. Skills Your Babysitter Needs

These are learn-able, and if you have a baby who has some of these behaviors, you will need to talk with the babysitter about them. Don’t assume that she will "instinctively" know what to do. Each child is unique and if what you do "works", share it. This is critically important if you have a baby who has special needs, was premature, is recovering from an illness, etc. You can spare her some frustrating minutes or hours.


Establishing the trust necessary for your babysitter to talk easily with you is an important skill, and forms the basis for you to work cooperatively together if a crisis arises with your baby. Your babysitter must feel free to call you to come home if a situation with either your baby - or with her - are getting out of control.

Your babysitter needs to know what YOU consider an emergency, and you need to know what SHE considers an emergency. Your telephone number, your doctor’s telephone number, 911, and nearby sources of help need to be clearly posted next to the telephone to help her react appropriately and quickly.

13C. Shaken Baby Syndrome

14C. The Only Correct Answer

Your sitter needs to know the causes of Shaken Baby Syndrome, the signs and symptoms of it and that immediate medical attention is critical, if these symptoms are ever observed. Your child won’t be the only one who will benefit.

She also needs to know that you know about SBS.

It is imperative that you ask your babysitter directly if there are any circumstances in which she might shake a baby. Some individuals "heard" that "if a child isn’t breathing" the child should be shaken to shock them into breathing . Again, this is wrong.

15C. Warning Signs of SBS

These are signs of traumatic head injury. They do not occur if a child has "fallen off the couch" or "fallen off the bed". They represent a LIFE-THREATENING INJURY to your child’s brain and require IMMEDIATE medical attention.

16C. What To Do If You See These Warning Signs

Take the child to the emergency room immediately, and be prepared to tell the doctor everything you know about your child’s health status. Describe all events occurring the day that your child became ill.

17C. The Best Advice

This is a reminder to tell your babysitter, each and every time you leave your child not to shake the baby under any circumstances. Repetition is good. Remind her every time.

18C. What To Tell Your Babysitter....

Most SBS cases (injuries and deaths) are a result of the caretaker’s raging outbursts because the baby is crying, and the caretaker is unsuccessful in "making" the baby stop.

The slogan "Better that the baby cries, than the baby dies.." will hopefully give permission to the caretaker to take a break, relax and calm down. Babysitters often feel that if the baby cries, they are inadequate, not doing their job, going to be fired, etc.... Give your babysitter permission to let the baby cry, when there is nothing else that can be done....


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