Warning Signs of Munchausen Syndrome by Proxy

Munchausen syndrome by proxy, now formally known as factitious disorder imposed on another, can take the form of child abuse in which a mother makes up or induces illnesses in her child. The caregiver uses the child's illnesses to join the child in the sick role and gain attention.

In the vast majority of cases, the mother is the one abusing the child this way; in other cases, the father, grandparent, or even babysitter may be the abuser. Some mothers go beyond making up symptoms to actually causing symptoms.

In time, children of this form of abuse can come to believe that they are really sick. Some children fear to contradict their mothers or feel that no one will believe the truth if they tell it.

This article covers the difficulties in recognizing this disorder, along with warning signs of Munchausen syndrome by proxy. It also discusses its consequences, complications, treatment, prevention strategies, and prognosis.

Munchausen Syndrome by Proxy Difficult to Identify

Some of the reasons why Munchausen syndrome by proxy is difficult for healthcare providers to identify are:

• The child has a combination of symptoms that do not conform to any known disease or disorder.
• Healthcare providers are not familiar with Munchausen syndrome and don't consider it to be a possible diagnosis.
• The physician tends to believe the very persuasive and compelling medical history the mother gives; she knows medical terminology and may have even worked in health care herself.
• The child has often been taken to different healthcare providers over time, at different hospitals, and there is no communication among these providers.

Warning Signs of Munchausen Syndrome by Proxy

Caretakers may take to extreme measures to fake symptoms in the child. This may include doing the following things:

• Adding blood to the child's urine or stool
• Withholding food so it looks like the child can't gain weight
• Heating up thermometers so it looks like the child has a fever
• Making up lab results
• Giving the child drugs to make the child throw up or have diarrhea
• Infecting an intravenous (IV) line to make the child sick

These signs can indicate that a child is the recipient of abuse:

• The child sees a lot of healthcare providers and is in the hospital a lot.
• The child has many medical tests, surgeries, or other procedures.
• The child's symptoms are strange and don't fit with any disease. The symptoms don't match the test results.
• The symptoms are reported by the caregiver and are not seen by the child's healthcare provider. The symptoms are gone in the hospital, but come back when the child goes home.
• Blood samples don't match the child's blood type.
• Drugs or chemicals are found in the child's urine, blood, or stool.

Potentially Deadly Results of Munchausen Syndrome by Proxy

Some mothers may severely hurt their children in order to cause symptoms. A mother may poison her child with medications, chemicals, or salt, give laxatives to cause diarrhea or syrup of ipecac to cause vomiting. Some may go as far as suffocating the child for brief periods of time to cause respiratory and nervous system problems.

Sometimes the abused child dies as a result of the induced medical procedures, such as surgery, done to treat the child's strange symptoms.

Complications of Munchausen Syndrome by Proxy

This disorder can lead to serious short- and long-term complications, including continued abuse, multiple hospitalizations, and the death of the victim. Research suggests that the death rate for victims of Munchausen syndrome by proxy is between six and 10 percent.

In some cases, a child victim of Munchausen syndrome by proxy learns to associate getting attention to being sick and develops Munchausen syndrome imposed on self. Considered a form of child abuse, Munchausen syndrome by proxy is a criminal offense.

How to Prevent Munchausen Syndrome by Proxy

There is no known way to prevent this disorder. However, once a diagnosis is clearly established, the safety of the child becomes paramount. Removing the child or other victims from the care of the person with Munchausen syndrome by proxy may be necessary to prevent further harm to the victim.

If you recognize symptoms of abuse, you can help prevent continued abuse. Putting an end the abuse may also mean preventing unnecessary, expensive, and possibly dangerous medical testing.

Treatment for Munchausen Syndrome by Proxy

In Munchausen syndrome by proxy, the child needs to be protected. This may involve removing the child from the caretaker's environment.

Children may need medical care to treat complications that could arise from injuries, infections, medication, surgeries, or tests. They may also need to see a child psychiatrist or other mental health professional to deal with the psychiatric trauma which can manifest as depression, anxiety, and post-traumatic stress disorder.

Parents or caregivers who abuse a child this way have a psychological problem that requires professional intervention. This usually involves individual and family therapy. Because they are a form of abuse, these cases are also reported to the authorities.

Prognosis of Munchausen Syndrome by Proxy

Generally, Munchausen syndrome by proxy is a very difficult disorder to treat and often requires a supportive multidisciplinary treatment approach. Social services, law enforcement, children's protective services, and physicians must function as a team to stop the behavior.

Summary

Munchausen syndrome by proxy is a mental health condition that causes a caregiver to fake illness in a child. It is a form of child abuse and must be reported to the authorities when discovered.

Caregivers can go to extreme lengths to fake illness and may sometimes end up causing the child real harm. Treatment for Munchausen syndrome involves medical and psychological treatment for the child as well as individual and family therapy for the caregiver doing the abuse.

Talk to a healthcare provider or the authorities if you recognize the signs of Munchausen syndrome by proxy. This can prevent further harm to the child and get the caregivers the help they need.