Munchausen syndrome by proxy is a mental illness and a form of child abuse. The caretaker of a child, usually a mother, either makes up fake symptoms or causes real symptoms to make it look like the child is sick.
No one is sure what causes Munchausen syndrome by proxy. Sometimes the person was abused as a child or has Munchausen syndrome (fake illness for themselves).
The mother can do extreme things to fake symptoms of illness in her child. For example, she may:
What are signs in a mother?
What are signs in a child?
To diagnose Munchausen syndrome by proxy, doctors and nurses have to see the clues. They have to review the child’s medical record to see what has happened with the child over time. Unfortunately, Munchausen syndrome by proxy often goes undiagnosed.
The child needs to be protected. They may need to be removed from the direct care of the parent.
Children may require medical care to treat complications from injuries, infections, medications, surgeries, or tests. They also need psychiatric care to deal with depression, anxiety, and post-traumatic stress disorder that can happen with child abuse.
Treatment usually involves individual and family therapy. Because this is a form of child abuse, the syndrome must be reported to the authorities.
If you think a child is being abused, contact a health care provider, the police, or child protective services.
Call 911 for any child in immediate danger because of abuse or neglect.
You can also call this national hotline. Crisis counselors are available 24/7. Interpreters are available to help in 170 languages. The counselor on the phone can help you figure out next steps. All calls are anonymous and confidential. Call Childhelp National Child Abuse Hotline 1-800-4-A-CHILD (1-800-422-4453)
Recognition of Munchausen syndrome by proxy in the child-parent relationship can prevent continued abuse and unnecessary, expensive, and possibly dangerous medical testing.
Factitious disorder by proxy
Dubowitz, H, Lane WG. Factitious disorder by proxy (Munchausen syndrome by proxy). In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 36.
Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.
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