Making one's own child ill in order to receive sympathy and attention from health-care professionals is a rare psychiatric disorder known as Munchausen Syndrome by Proxy that impacts an estimated two in 100,000 children.

Considered one of the most harmful forms of child abuse, Munchausen Syndrome by Proxy (MSP) was named for Baron von Munchausen, an 18th-century German dignitary with a reputation for fabricating the truth. ("By proxy" means through a substitute.)

In MSP, the adult (usually a female) exaggerates a child's "symptoms" and/or deliberately makes the person under her care, usually a preschool-aged child, suffer.

Conditions faked by parents or caregivers include: failure to thrive, allergies, asthma, vomiting, diarrhea, seizures, and infections. Sadly, the afflicted adult may induce symptoms by starving a child or using household substances (such as Ipecac syrup to induce vomiting) or cleaning solvents to cause skin rashes, burns, and breathing difficulties. There have also been cases of blood or urine sample contamination.

The MSP-stricken adult longs to develop a relationship with the health-care provider and has such a strong need for the child to be seen as sick that defenseless, children have also undergone painful or risky procedures in a desperate attempt for the troubled adult to garner the special attention she craves.

The problem is difficult to diagnose because the mentally-disturbed adult is often so well versed in medical details and symptoms that she impresses medical professionals as a devoted mother or caregiver.

Getting Help for MSP

Though the exact cause of MSP is not known, both biological and psychological factors seem to play role in the development of this disorder. The adult may have experienced the early loss of a parent or may have been abused or neglected during her childhood. Evidence also suggests that marital problems or other major stressors could trigger an episode of MSP.

Noticing suspicious behavior can help save a child's life. A child with multiple hospitalizations (often with strange symptoms) or symptoms that become worse but are reported only by the mother and never witnessed by medical staff may be signs the child is in danger. Other signs are more than one unusual illness or the death of another child in the family.

Reporting your concerns to a health-care professional can safeguard a child. Managing MSP requires intervention from social workers, health-care providers, and police. Since it is considered a form of child abuse, law enforcement personnel are usually involved and social services may find it necessary to remove the child from the family.

Treating people with MSP is complex. They are often in deep denial about having a problem and are unable to separate fact from fiction. Psychotherapy and medication can be helpful. Children often need medical care to treat injuries inflicted by the parent, as well as psychiatric care to deal with depression, anxiety, and other conditions provoked by child abuse. Some children may died from infections or other injuries inflicted by parents with MSP.

Finally, if you have an urge to harm your child seek psychiatric help immediately.

American Academy of Pediatrics

The Cleveland Clinic

American Academy of Family Physicians

National Institutes of Health