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Munchausen Syndrome by Proxy (Child Abuse in the Medical Setting)

Munchausen Syndrome by Proxy (Child Abuse in the Medical Setting) is a topic covered in the Select 5-Minute Pediatrics Topics.

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  • Symptoms of illness in a child that are exaggerated, fabricated, or induced by a caretaker. There is usually no underlying health disorder in the child.
  • Results in harm to the child victim through repeated interactions with the medical care system, including unnecessary tests, medications, and surgeries
  • Known by many names, including the following:
    • “Pediatric condition falsification”
    • “Caregiver-fabricated illness”
    • “Medical child abuse”
    • “Factitious disorder by proxy”
  • All refer to harm that befalls children through the actions of a caregiver in a medical setting.
  • Symptoms decrease when the child is separated from the perpetrator.


  • Rare, with no typical presentation. The most commonly described symptoms include apnea, seizures, factitious fevers, feeding and GI problems, failure to thrive, behavioral problems, bleeding, and sepsis.
  • Presenting symptoms may present along a spectrum of severity from mild to fatal.
  • Most victims are <4 years of age, but victims may often be older children.
  • Males and females are equally represented.
  • Symptoms may be present for years before factitious illness is considered and diagnosed.
  • Morbidity is significant; cases may be fatal, especially those involving surreptitious administration of medications, poisoning, or inducing apnea.


  • The parent, most commonly the mother, exaggerates, fabricates, or induces the illnesses.
  • The term Munchausen syndrome by proxy refers to specific instances where the caregiver is motivated by a desire for self-aggrandizement. As such, it only defines a subset of factitious illnesses.
  • Medical providers are advised to concentrate on the specific harm done and the patient’s safety rather than on the caregiver’s motives.

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Cabana, Michael D., editor. "Munchausen Syndrome By Proxy (Child Abuse in the Medical Setting)." Select 5-Minute Pediatrics Topics, 7th ed., Wolters Kluwer Health, 2015. Medicine Central, im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14055/all/Munchausen_Syndrome_by_Proxy__Child_Abuse_in_the_Medical_Setting_.
Munchausen Syndrome by Proxy (Child Abuse in the Medical Setting). In: Cabana MD, ed. Select 5-Minute Pediatrics Topics. 7th ed. Wolters Kluwer Health; 2015. https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14055/all/Munchausen_Syndrome_by_Proxy__Child_Abuse_in_the_Medical_Setting_. Accessed April 18, 2019.
Munchausen Syndrome by Proxy (Child Abuse in the Medical Setting). (2015). In Cabana, M. D. (Ed.), Select 5-Minute Pediatrics Topics. Available from https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14055/all/Munchausen_Syndrome_by_Proxy__Child_Abuse_in_the_Medical_Setting_
Munchausen Syndrome By Proxy (Child Abuse in the Medical Setting) [Internet]. In: Cabana MD, editors. Select 5-Minute Pediatrics Topics. Wolters Kluwer Health; 2015. [cited 2019 April 18]. Available from: https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14055/all/Munchausen_Syndrome_by_Proxy__Child_Abuse_in_the_Medical_Setting_.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Munchausen Syndrome by Proxy (Child Abuse in the Medical Setting) ID - 14055 ED - Cabana,Michael D, BT - Select 5-Minute Pediatrics Topics UR - https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14055/all/Munchausen_Syndrome_by_Proxy__Child_Abuse_in_the_Medical_Setting_ PB - Wolters Kluwer Health ET - 7 DB - Medicine Central DP - Unbound Medicine ER -