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Munchausen Syndrome By Proxy

What is Munchausen syndrome by proxy?

Munchausen syndrome by proxy is also known as MSBP. It happens when a child is made to look very sick or have a very bad disease. The caretaker, usually the mother, makes up symptoms of illness and causes harm to the child. This often results in unnecessary tests and treatments. This condition is a form of abuse where very young children, especially infants, are the common victims. The condition may also happen to children up to 16 years of age.

What causes MSBP?

This may be caused by a mental condition or history of neglect on the part of the abuser. Most abusers were also victims of physical or emotional abuse during their childhood. The caretaker harms the child usually to get attention and sympathy they never had. The attention and acceptance they get from caregivers makes them continue to harm their children.

What are the signs and symptoms of MSBP?

There may be few or no signs of injury in this condition. The child is often brought to a hospital for other symptoms that are unusual for the disease. The child may appear small and underweight for his age. The symptoms usually improve in the hospital but come back when at home with the caretaker. The caretaker may report that the child has:

  • Bleeding.

  • Diarrhea (frequent watery bowel movement) or vomiting (throwing up).

  • Fever.

  • Seizures (convulsions) or mental depression.

  • Skin rashes.

  • Trouble breathing.

How is MSBP diagnosed?

The diagnosis of this condition is not easy. The child usually has a history of multiple illnesses and often multiple surgeries. The caretaker may appear as a caring and loving parent so any clue of abuse is hardly seen. The caretaker may also give false information about the symptoms the child has. Careful and detailed medical history may sometimes be needed from other family members, relatives, or friends. The child is also checked for signs of physical abuse. The following may also be needed:

  • Documentation: This method notes how the child reacts when he is with his caretaker. The actions and behavior of the caretaker towards the child's caregivers may also be noted.

  • Separation: The child may be taken away from his caretaker for a while. Once separated, the child's behavior and condition are observed. This may help diagnose the condition if the child gets well without any treatment.

  • Video monitoring: This uses a video to record how the caretaker behaves when left alone with the sick child. It can help the child's caregivers get strong evidence of abuse.

How is MSBP treated?

A child who has been abused may be placed in a special home or day care center. Special services may be used to ensure the child's safety and health. Treatment may also include any of the following:

  • For the child:

    • Counseling: Caregivers may talk to the child, or other family members, friends, or the abuser about physical abuse. Caregivers may explain the problems that can happen if child abuse is not noticed or stopped.

    • Medicines: Caregivers may give the child medicine to control his symptoms. He may need antibiotics or a tetanus shot if there is an open wound. Medicines may also be given if he has other medical conditions.

    • Nutrition: The child may be given a special diet to gain back lost weight. A caregiver called a dietitian may provide the child with the right food that he must eat. Ask the child's caregiver for information on the diet that the child may need.

  • For the caretaker:

    • Medicines: Medicines may be given to treat depression or anxiety (worry).

    • Psychotherapy: This is a type of counseling that is usually done in a series of meetings or talks. This can help people understand why physical abuse happens, and learn about problems that an abuser might have.

Where can I get support and more information?

Reporting physical abuse may be hard to do, but it is very important. By reporting abuse, the child will get the help that he needs to stop the abuse from happening or continuing. Talk to the child and help him discuss his feelings. The child's caregiver can help you, or other family members and friends understand how to support the child. Contact the following for more information:

  • American Academy of Pediatrics
    141 Northwest Point Boulevard
    Elk Grove Village , IL 60007-1098
    Phone: 1- 847 - 434-4000
    Web Address: http://www.aap.org

Care Agreement

You have the right to help plan the child's care. To help with this plan, you must learn about the child's health condition and how it may be treated. You can then discuss treatment options with the child's caregivers. Work with them to decide what care may be used to treat the child.The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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