Watch for Warning Signs of Child Abuse--EMBARGOED until 3/10/13 at 11:01pm CST

Abused babies often have previous suspicious injuries before they begin crawling

(RxWiki News) If possible victims of child abuse could be identified early on, it could save a lot of heartache and pain for everyone involved. Paying attention to babies' injuries may be an important step.

A recent study found that infants who are victims of child abuse are more likely to have had another earlier unlikely injury when they were even younger – before they could even crawl.

Among a group of abused and nonabused babies evaluated at a hospital, only the abused children had histories of previous injuries, such as bruising.

The researchers found that babies with a suspicious minor injury, especially before they begin crawling, are more than four times more likely to become later victims of child abuse.

insight: Report suspected child abuse.

The study, led by Lynn K. Sheets, MD, of the Medical College of Wisconsin in Milwaukee, aimed to better understand what might be warning signs of abuse in babies.

The researchers looked 401 babies under 1 year old who had been evaluated for child abuse in a hospital. In each child's case, the hospital's Child Protection Team either determined that there was definitely child abuse going on or that no abuse occurred after the evaluation.

Then the researchers looked at the previous medical records of these infants for "sentinel" injuries. A sentinel injury is a previous injury that appeared suspicious either because the baby was not yet crawling or the explanation the parents gave was an unlikely cause for the abuse.

Of the 200 babies in the study who had definitely been abused, 27.5 percent were found to have a previous sentinel injury. Of the 100 babies who may have been abused, but it was not yet clear, 8 percent of them had a previous sentinel injury.

Among the 101 babies found not to be victims of abuse at all, none had a previous sentinel injury.

The most common earlier sentinel injury found among the children who had definitely been abused was bruising, which 80 percent of the children with sentinel injuries had. In addition, 11 percent had a mouth injury, and 7 percent had another injury.

The sentinel injuries generally occurred very early in the babies' lives. About two thirds (66 percent) of the babies had a sentinel injury before they were 3 months old, and 95 percent of them had the injury before they were 7 months old.

The researchers found that medical providers were aware of the previous sentinel injury in 42 percent of the cases where one existed.

"Previous sentinel injuries are common in infants with severe physical abuse and rare in infants evaluated for abuse and found to not be abused," the researchers wrote. "Detection of sentinel injuries with appropriate interventions could prevent many cases of abuse."

The study was published March 11 in the journal Pediatrics. The research was funded by the Child Abuse Prevention Fund of Children’s Hospital of Wisconsin, the Wisconsin Children’s Trust Fund, and the Department of Pediatrics at the Medical College of Wisconsin. One author has provided paid expert testimony in court cases related to child abuse. The other authors declared no conflicts of interest.


Review Date: 
March 10, 2013