Factitious disorder by proxy
Munchausen syndrome by proxy is a mental illness and a form of child abuse. The caretaker of a child, most often a mother, either makes up fake symptoms or causes real symptoms to make it look like the child is sick.
No one is sure what causes Munchausen syndrome by proxy. Sometimes, the person was abused as a child or has Munchausen syndrome (fake illness for themselves).
The mother can do extreme things to fake symptoms of illness in her child. For example, she may:
What are signs in a mother?
What are signs in a child?
To diagnose Munchausen syndrome by proxy, providers have to see the clues. They have to review the child's medical record to see what has happened with the child over time. Very often, Munchausen syndrome by proxy goes undiagnosed.
The child needs to be protected. They may need to be removed from the direct care of the parent.
Children may require medical care to treat complications from injuries, infections, medicines, surgeries, or tests. They also need psychiatric care to deal with depression, anxiety, and post-traumatic stress disorder that can happen with child abuse.
Treatment most often involves individual and family therapy. Because this is a form of child abuse, the syndrome must be reported to the authorities.
If you think a child is being abused, contact a provider, the police, or child protective services.
Call 911 for any child in immediate danger because of abuse or neglect.
You can also call this national hotline. Crisis counselors are available 24/7. Interpreters are available to help in 170 languages. The counselor on the phone can help you figure out the next steps. All calls are anonymous and confidential. Call Childhelp National Child Abuse Hotline 1-800-4-A-CHILD (1-800-422-4453).
Recognition of Munchausen syndrome by proxy in the child-parent relationship can prevent continued abuse and unnecessary, expensive, and possibly dangerous medical testing.
Dubowitz H, Lane WG. Abused and neglected children. In: Kliegman RM, Stanton BF, St Geme JW III, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 40.
Shapiro R, Farst K, Chervenak CL. Child abuse. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 24.
Last reviewed on: 7/10/2015
Reviewed by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.