Citation

Ingelfinger JR. Acta Paediatr. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, John Wiley and Sons)

DOI

10.1111/apa.17022

PMID

37916611

Abstract

It is a truism that human beings are fully dependent on caregivers in their first year of life, and still, considerably, in their early years. Generally, the bonding between parents and child ensures devoted, protective care. Interruption of such bonding may have far-reaching effects in each and every realm of a child's future--throughout the lifespan. It is tough to parent, and everyone makes mistakes, mainly rectifiable. However, child abuse does occur, its origins variable; according to the National Society for the Prevention of Cruelty to Children (NSPCC), up to half a million children in the United Kingdom suffer abuse or neglect yearly (~3.9% of the childhood population in the United Kingdom).1 But a subcategory that is now termed medical child abuse is unusual and often eludes detection.2 Signs of medical child abuse include symptoms only observed by the affected child's parent (or closest caregiver), unusual presentations and responses to treatment, repeated seeking of further medical options, and isolation and withdrawal from normal activities. The symptoms often cease when the child is not in the care of the person instigating the findings. Because the manifestations of medical child abuse may be elusive but the implications potentially devasting, even fatal, being aware of the spectre of such abuse is critical to its detection.

Thus, solving a case of medical child abuse can be lifesaving for the child involved. However, misdiagnosis and incorrect attribution of medical child abuse to a parent or other caregiver may have devastating consequences for all concerned, as it may lead to separation of the child from the family and incarceration of the parent on top of medical repercussions. It is also wise to remember that patients suffering from medical child abuse may well have other medical conditions, rendering the situation even more perplexing. And certain types of medical child abuse, such as salt poisoning, which we will consider here, may be difficult to parse as to whether intentional or accidental...

Language: en