Caregivers who have poor parenting skills, little or no parenting support, or unrealistic expectations of normal behavior for infants or young children may be more likely to harm a child. They often do not know what behaviors are normal for babies or young children and have unrealistic expectations, such as expecting a 9-month-old to sit quietly for a long period of time or expecting a baby not to cry.

Babies or young children who are difficult to care for, such as those who have colic, demanding temperaments, or physical disabilities, may trigger a loss of control in a frustrated caregiver. A common cause of loss of control is a crying infant who does not respond to usual measures of comforting.

Caregivers who may be more likely to shake or throw a baby or young child include people who:

• Were abused or neglected as children.
• Have problems with drugs or alcohol.
• Do not know how to handle their stress or use unhealthy stress management techniques, such as violence. Abusive tendencies may surface during stressful periods, such as when the person is ill or having financial troubles.
• Have mental health problems, such as depression, that interfere with their ability to cope.
• Have no one they can count on for help in caring for the baby.
• Have a child with acute or chronic medical or developmental problems.