A Review on Medical Child Abuse and Child Protection

Background Medical child abuse describes a child receiving unnecessary, harmful, or potentially harmful medical care at the caretaker's instigation. Objectives To focus on medical child abuse as an entity and emphasize its epidemiology, clinical presentations, prevention, and management. Results In the UK, the annual incidence of medical child abuse in children below one year increased to 3:100,000, while its prevalence in Arabs, including Iraq, is ambiguous due to lack of evidence and improper clinician's awareness. The mean age at diagnosis is 14 months to 2.7 years. Female caregivers are the most common offenders. Clinically, medical child abuse could fit into three stages; falsification of illness story, falsification of illness story and physical signs' fabrication, or induction of illness in children. A successful diagnosis mandates a comprehensive review of medical records to identify discrepancies between caregivers' stories versus clinical findings or investigations. Management requires recognizing abuse, halting it, securing the child's safety, maintaining the family's integrity when possible, and aborting unnecessary lateral referrals within the healthcare system. Conclusion Reported cases of medical child abuse are increasing steadily, while less severe ones go unrecognized. No diagnostic tool can help other than the physician's high index of suspicion. The management follows the same principles applied for other forms of child abuse, while good medical practice ensures its prevention.

A child whose parent insists on recurrent medical admissions

Factitious disorder imposed on another (FDIA) occurs when a caregiver deliberately falsifies illness in a child despite the absence of obvious external rewards. The caregiver receives the diagnosis of FDIA and the child is a victim of medical child abuse. Factitious disorder imposed on another is associated with a high risk of morbidity and mortality. Warning signs that raise concern for FDIA include atypical presentations, multiple illnesses, seeking care from multiple providers, resisting reassurances that the child is healthy, and testing/observations that are inconsistent with the caregiver’s report. The assessment should include a detailed review of reported signs/symptoms as well as objective findings in the patient’s medical record. All physicians involved in the child’s care should come to a consensus regarding ongoing management, and it may be helpful to consult with a pediatrician with specialty training in child abuse. Treatment includes ensuring the child’s safety, discontinuing unnecessary medical care, and providing psychotherapy.

Medical Child Abuse: When Parents Harm Their Children

This brief review of medical child abuse and treatment approaches is meant to highlight a problem which gains in frequency lately. That of a parent, usually, who is expected to love and care for the child actually harming that child in ways that may result in many medical examinations, painful invasive procedures, and even unnecessary surgeries.

Medical Child Abuse: When Parents Harm Their Children

This brief review of medical child abuse and treatment approaches is meant to highlight a problem which gains in frequency lately. That of a parent, usually, who is expected to love and care for the child actually harming that child in ways that may result in many medical examinations, painful invasive procedures, and even unnecessary surgeries.