The lecture has been given on Nov. 7th, 2010 by Dr. Jamal.

1. • OtherOther namesnames::
-Child abuse.-Child abuse.
-Battered baby syndrome.-Battered baby syndrome.
-Child neglect.-Child neglect.
• DefinitionDefinition: non accidental, physical, emotional,: non accidental, physical, emotional,
sexual, or other forms of injuries that are madesexual, or other forms of injuries that are made
deliberately by parents or other care-takers thatdeliberately by parents or other care-takers that
violate the community standards concerning theviolate the community standards concerning the
treatment of children.treatment of children.

2. Epidemiology:Epidemiology:
-Any child is at risk for abuse.-Any child is at risk for abuse.
-Less than 4 years, usually less than 1 year.-Less than 4 years, usually less than 1 year.
-Mental+/_ intellectual handicap.-Mental+/_ intellectual handicap.
-Tantrum.-Tantrum.
-Chronic diseases.-Chronic diseases.
-H. of prematurity, SGA, N.N. separation or multiple births.-H. of prematurity, SGA, N.N. separation or multiple births.
-Regarding the abusers:-Regarding the abusers:
May be from any socioeconomic, cultural & ethnic group.May be from any socioeconomic, cultural & ethnic group.
Social isolation, depression or H. of drug abuse.Social isolation, depression or H. of drug abuse.
H. of abuse as a child.H. of abuse as a child.
H. of mental illness.H. of mental illness.
H. of violent temperament.H. of violent temperament.

3. • Main features:Main features:
– Fractures.Fractures.
– Subdural hematoma.Subdural hematoma.
– Retinal hemorrhage .Retinal hemorrhage .
– Bruises of various ages.Bruises of various ages.
– Burns.Burns.
– Lacerations.Lacerations.

4. • Suggestive points:Suggestive points:
– Accidental detection of old trauma.Accidental detection of old trauma.
– Delay.Delay.
– Unacceptable explanations.Unacceptable explanations.
– Abnormal Child-parent interaction.Abnormal Child-parent interaction.

5. Diagnostic signs of NAIDiagnostic signs of NAI
• Certain bites.Certain bites.
• Certain burns and scalds.Certain burns and scalds.
• Certain bruises and fractures.Certain bruises and fractures.

6. SUIDSSUIDS
• DefinitionDefinition: Sudden death of an infant that is unexpected by history &: Sudden death of an infant that is unexpected by history &
unexplainable by a thorough post mortem examination which include a completeunexplainable by a thorough post mortem examination which include a complete
autopsy, investigation of the scene of death &review of the medical history.autopsy, investigation of the scene of death &review of the medical history.
• EpidemiologyEpidemiology::
Leading causeLeading cause of infant death inof infant death in somesome ofof thethe developeddeveloped countries.countries.
Approximate incidence is 2 in 1000 live births.Approximate incidence is 2 in 1000 live births.
Peak incidence is at 2-4 months.Peak incidence is at 2-4 months.
Typical victim is found dead in the morning in bed after a previous ordinary night.Typical victim is found dead in the morning in bed after a previous ordinary night.
RiskRisk factorsfactors includeinclude::
-Prone sleeping position.-Prone sleeping position.
-Soft bedding, over-heating& over bundling.-Soft bedding, over-heating& over bundling.
-Prematurity.-Prematurity.
-Being a member of the twin when the other member has died of SUIDS-Being a member of the twin when the other member has died of SUIDS
-Recent illness.-Recent illness.
-Bottle feeding.-Bottle feeding.
-Maternal smoking, drug abuse or infection.-Maternal smoking, drug abuse or infection.
-Sharing bed with the mother.-Sharing bed with the mother.

7. SUIDSSUIDS
• DefinitionDefinition: Sudden death of an infant that is unexpected by history &: Sudden death of an infant that is unexpected by history &
unexplainable by a thorough post mortem examination which include a completeunexplainable by a thorough post mortem examination which include a complete
autopsy, investigation of the scene of death &review of the medical history.autopsy, investigation of the scene of death &review of the medical history.
• EpidemiologyEpidemiology::
Leading causeLeading cause of infant death inof infant death in somesome ofof thethe developeddeveloped countries.countries.
Approximate incidence is 2 in 1000 live births.Approximate incidence is 2 in 1000 live births.
Peak incidence is at 2-4 months.Peak incidence is at 2-4 months.
Typical victim is found dead in the morning in bed after a previous ordinary night.Typical victim is found dead in the morning in bed after a previous ordinary night.
RiskRisk factorsfactors includeinclude::
-Prone sleeping position.-Prone sleeping position.
-Soft bedding, over-heating& over bundling.-Soft bedding, over-heating& over bundling.
-Prematurity.-Prematurity.
-Being a member of the twin when the other member has died of SUIDS-Being a member of the twin when the other member has died of SUIDS
-Recent illness.-Recent illness.
-Bottle feeding.-Bottle feeding.
-Maternal smoking, drug abuse or infection.-Maternal smoking, drug abuse or infection.
-Sharing bed with the mother.-Sharing bed with the mother.