St. Luke's Hospital
Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
Find a Physician Payment Options Locations & Directions
Follow us on: facebook twitter Mobile Email Page Email Page Print Page Print Page Increase Font Size Decrease Font Size Font Size
America's 50 Best Hospitals
Meet the Doctor
Spirit of Women
Community Health Needs Assessment
Home > Health Information

Multimedia Encyclopedia

    Print-Friendly
    Bookmarks

    Munchausen syndrome by proxy

    Munchausen syndrome by proxy is a form of child abuse in which a parent induces real or apparent symptoms of a disease in a child.

    Causes

    This syndrome almost always involves a mother abusing her child by seeking unneeded medical attention for the child. It is rare and poorly understood. The cause is unknown.

    The mother may fake symptoms of illness in her child by adding blood to the child's urine or stool, withholding food, falsifying fevers, secretly giving the child drugs to make the child throw up or have diarrhea, or using other tricks, such as infecting intravenous (given through a vein) lines to make the child appear or become ill.

    These children are often hospitalized with groups of symptoms that don't quite fit any known disease. Frequently, the children are made to suffer through unnecessary tests, surgeries, or other uncomfortable procedures.

    The parent is usually very helpful in the hospital setting and is often appreciated by the nursing staff for the care she gives her child. She is often seen as devoted and self-sacrificing, which can make medical professionals unlikely to suspect the diagnosis of Munchausen syndrome by proxy.

    Her frequent visits unfortunately also make the child accessible to her so that she can induce further symptoms. Changes in the child's condition are almost never witnessed by hospital staff and almost always occur only in the mother's presence.

    Munchausen syndrome occurs because of psychological problems in the adult, and is generally an attention-seeking behavior. The syndrome can be life-threatening for the child involved.

    Symptoms

    • The child's symptoms do not fit a classical picture of illness or do not fit together well.
    • The child's symptoms improve at the hospital but reappear at home.
    • The parent is overattentive or "too helpful."
    • The parent is often involved in a health-care field, such as nursing.

    Exams and Tests

    • Blood samples used for lab work do not match the patient's blood type.
    • The presence of drugs or chemicals in blood, stool, or urine samples cannot be accounted for.

    Treatment

    Once the syndrome is recognized, the child needs to be protected and removed from direct care of the parent. The affected parent should not be accused directly, but offered help.

    Because this is a form of child abuse, the syndrome must be reported to the authorities. Psychiatric counseling will be recommended for the parent involved, but since the disorder is rare, very little is known about effective treatment.

    Outlook (Prognosis)

    This is a difficult disorder to treat in parents. There is little information available about the best types of treatment or what the outcome will be. It usually requires years of psychiatric support.

    Children may require medical care to treat injuries the parent inflicted, as well as psychiatric care to deal with depression, anxiety, and other conditions that can be provoked by child abuse. Some children may die from infections or other injuries inflicted by parents with Munchausen syndrome by proxy.

    Possible Complications

    The child can have complications from injuries, infections, medications, surgeries, or tests. Risk for psychological complications like depression, anxiety, post-traumatic stress disorder, and others is increased in survivors of child abuse.

    When to Contact a Medical Professional

    This condition is diagnosed by the health care provider when the child is treated for various symptoms. If you find that you have urges to harm your child, seek psychiatric care immediately.

    Prevention

    Recognition of Munchausen syndrome by proxy in the child-parent relationship can prevent continued abuse and unnecessary, expensive, and possibly dangerous medical testing.

    References

    Johnson CF. Abuse and neglect of children. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 36.

    BACK TO TOP

          A Closer Look

            Self Care

              Tests for Munchausen syndrome by proxy

                Review Date: 2/21/2011

                Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine; David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

                The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
                adam.com

                A.D.A.M. content is best viewed in IE9 or above, Fire Fox and chrome browser.


                Back  |  Top
                About Us
                Contact Us
                History
                Mission
                Locations & Directions
                Quality Reports
                Annual Reports
                Honors & Awards
                Community Health Needs
                Assessment

                Newsroom
                Services
                Brain & Spine
                Cancer
                Heart
                Maternity
                Orthopedics
                Pulmonary
                Sleep Medicine
                Urgent Care
                Women's Services
                All Services
                Patients & Visitors
                Locations & Directions
                Find a Physician
                Tour St. Luke's
                Patient & Visitor Information
                Contact Us
                Payment Options
                Financial Assistance
                Send a Card
                Mammogram Appointments
                Health Tools
                My Personal Health
                mystlukes
                Spirit of Women
                Health Information & Tools
                Clinical Trials
                Health Risk Assessments
                Employer Programs -
                Passport to Wellness

                Classes & Events
                Classes & Events
                Spirit of Women
                Donate & Volunteer
                Giving Opportunities
                Volunteer
                Physicians & Employees
                For Physicians
                Remote Access
                Medical Residency Information
                Pharmacy Residency Information
                Physician CPOE Training
                Careers
                Careers
                St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
                Copyright © St. Luke's Hospital Website Terms and Conditions  |  Privacy Policy  |  Patient Notice of Privacy Policies PDF Sitemap St. Luke's Mobile