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SBS Signs and Symptoms	Medical Findings
Lethargy/ decreased muscle tone/limp Extreme irritability Seizures— most noticeable as rolling of eyes upward into head Semi-consciousness Decreased appetite Vomiting Constipation Difficulty breathing Dilated pupils Blood spots/pooling of blood in eyes Bruises— shoulders, neck, ribs area back and front, arms, wrists	Brain swelling Retinal hemorrhage (usually bilateral) Subdural hemorrhage Subarachnoid hemorrhage Rib fractures Long bone fractures, including chip FXS Grasp bruises around ribs, neck head, arms & wrists Cerebral infarction
Life Time Disabilities	Red Flags
Permanent brain damage Partial or total blindness Development delays Seizures Paralysis Cerebral palsy Hearing loss Speech, eating, & learning difficulties Mental retardation Behavioral difficulties Vegetative state	Injuries incompatible with history given Recent family stresses, such as new baby Care giver not seeking medical attention Apparent unrealistic expectations of infant History of diapering or toilet-training difficulties Colicky baby