Battered child syndrome is defined as the collection of injuries sustained by a child as a result of repeated mistreatment or beating. If a child’s injuries indicate intentional trauma or appear to be more severe than could reasonably be expected to result from an accident, battered child syndrome should be suspected (International Society for Prevention of Child Abuse and Neglect).
In such cases, an investigator must do more than simply collect information about the currently reported injury. A full investigation requires interviewing possible witnesses about other injuries that the child may have suffered in the past, obtaining the parents’ explanation for those injuries, and assessing the conclusions of medical professionals who may be familiar with the victim and his/her health care.
Most Infant Deaths are Related to Head Injuries
Unfortunately, the more careful and planned out the killing is, the less likely it is that a medical explanation for the death will be found. Most fatal injuries resulting from abuse are much more subtle than poisoning, beating, bludgeoning, shooting, or strangulation. For example, suffocation often leaves absolutely no medical sign of the cause of death. Most infant deaths are related to head injuries, some of which leave no external sign of trauma (International Society for Prevention of Child Abuse and Neglect).
In cases of shaken baby syndrome, skull fractures often aren’t present and no external signs of trauma are evident. The shaking necessary to cause death or severe intracranial injury is never an unintentional or non-abusive action. These injuries are caused by a violent, sustained action in which the infant’s head, which lacks muscular control, is violently whipped forward and backward, hitting the chest and shoulders.
Shaken baby syndrome occurs primarily in children 18 months of age or younger. It is most often associated with infants less than a year old, because their necks lack muscle control and their heads are heavier than the rest of their bodies.
Simple household falls, cardiopulmonary resuscitation (CPR), and tossing a baby in the air in play are not good explanations for retinal hemorrhage. There is not enough force involved in minor falls and play activities to cause retinal hemorrhage.
In cases of Munchausen syndrome by proxy, a parent or caretaker suffering from Munchausen syndrome attempts to bring medical attention to themselves by injuring or inducing illness in their children. The parent then may try to resuscitate the child or to have paramedics or hospital personnel save the child.
Sudden infant death syndrome (SIDS) is a diagnosis made when there is no other medical explanation for the abrupt death of an apparently healthy infant. When a baby dies from shaking, intracranial injury, peritonitis (inflammation of the peritoneum, that is, the membrane that lines the abdominal cavity), apparent suffocation, or any other identifiable cause, SIDS is not even considered a possibility.
Sudden Infant Death Syndrome is not a Homicide
A SIDS death is not a homicide, and apparent SIDS cases must be approached with great sensitivity. However, before SIDS can be ruled the cause of death, the investigator must ensure that every other possible medical explanation has been explored and that there is no evidence of any other natural or accidental cause for the child’s death (International Society for Prevention of Child Abuse and Neglect).
Both medical and legal professions are key in identifying non-accidental trauma inflicted on children. These professionals account for an increase in the number of identified child abuse homicides. Sadly, however, there will always be some children who die of abuse that is never discovered.
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