Munchausen by Proxy (MBP)- also known as Factitious Disorder by Proxy, Munchausen by Proxy Syndrome, and Munchausen Syndrome by Proxy - is a very dangerous form of child maltreatment. MSP is a parenting disorder where parents, usually the mother, fabricate symptoms in their children, thus subjecting the child to unnecessary medical tests and/or surgical procedures. In some cases, the parents also inflict injury and can kill their children in the process. In general, the detrimental effect is caused by applying foreign substances or by airway obstruction (International Society for Prevention of Child Abuse and Neglect Fact Sheet, 2003).
Sometimes MBP starts with a child receiving medical attention for a true illness. In order to continue receiving attention from medical personnel, the caregiver may exaggerate, prolong, or produce additional symptoms.
Symptoms of Munchausen Syndrome by Proxy
Symptoms in the child who is a victim of Munchausen syndrome by proxy vary, depending on the actions of the abuser. The caregiver may report false symptoms (such as periods of not breathing during sleep, known as apnea), 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 (International Society for Prevention of Child Abuse and Neglect).
Less commonly, the offending caregiver will report symptoms of a behavioral problem or mental (psychiatric) condition such as attention deficit hyperactivity disorder (ADHD) rather than a physical illness.
Munchausen Syndrome by Proxy – Warning Signs
Physicians are sometimes the first to recognize Munchausen syndrome by proxy. Recognition of Munchausen syndrome in the child-parent relationship can prevent continued abuse and unnecessary, expensive, and possibly dangerous medical testing. The following warning signs may alert primary health care providers that a parent has Munchausen syndrome by proxy:
- A child has a recurring or unusual illness for which no adequate explanation can be found. The parent has the child go through many different tests and evaluations, and the child continually fails to respond to or tolerate medical treatments that in most cases are effective.
- Symptoms occur or begin only when the caregiver is with or has recently been with the child. Symptoms improve or do not occur when the caregiver is absent.
- The other parent (usually the father) is noticeably absent. He is uninvolved even though a child's condition may be or appear to be serious.
- Evidence proves that the parent has given false information to health professionals or others.
- Normal test results do not reassure the parent. She is inappropriately calm or euphoric when her child's condition is most severe.
- The caregiver makes an exceptional effort to become friendly and close to medical staff. She may seek medical care for the child from a series of doctors if current relationships become strained.
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