Good things come in small packages‐ unique neonatal anatomic features

It is commonly stated that children are not little adults. This fact is demonstrated by the differences in traumatic injuries of the head and the chest. Abusive head trauma, formerly known as Shaken Baby Syndrome, is often neurologically devastating. When comparing neurologic outcomes children under the age of 1 far worse then older children and adults. This comes from studies which suggest that there is a critical age when the brain is most able to compensate for injuries. Traumatic injuries of the thorax are similarly different in children when compared to adults. The rib cage of a child is more flexible. Pulmonary contusions are commonly seen in children without concurrent rib fractures. Studies have shown up to 50% of thoracic injuries occur without rib fractures. When evaluating a child it's important not to be deceived by the lack of fractures and still have a high suspicion of underlying pulmonary injury. The thoracic system is directly affected by the abdominal cavity in neonates. Abdominal congenital lesions can directly affect the respiratory status of neonates. The anatomical differences seen in children and adults are crucial in the evaluation and treatment of traumatic injuries.