Munchausen syndrome by proxy

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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.

This syndrome almost always involves a mother abusing her child by seeking unneeded medical attention for him or her. 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, surreptitiously giving emetics or cathartics to simulate vomiting or diarrhea, or using other maneuvers (such as infecting IV lines to make the child appear or become ill).

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

The affected 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 commonly seen as devoted and unusually self-sacrificing, which can make medical professionals unlikely to suspect the diagnosis.

Her frequent visits unfortunately also make the child accessible to her so that she can induce further symptoms. Changes in physical exam or vital signs are almost never witnessed by hospital staff and almost always occur in presence of the mother.

Munchausen syndrome occurs because of psychological problems in the adult, and is generally an attention-seeking behavior. However, the syndrome can be life-threatening for the child involved because this unusual behavior can escalate to the point of severe physical harm or even death.

Review Date: 06/13/2006
Reviewed By: Benjamin W. Van Voorhees, MD, MPH, Assistant Professor of Medicine and Pediatrics, The University of Chicago, Chicago, IL. Review provided by VeriMed Healthcare Network.