What is Battered baby syndrome?

DEFINITION:
1. Clinical  condition  in young children usually below 3 years-who received repeated non-accidental violence or injury on one or more occasions at the hands of the parents, guardian, foster parent.
2. In addition to the physical injury there may also be deprivation of nutrients, affection in circumstances, which indicate that such deprivation is not accidental.
CAUSES:
1. The victim may be a illegitimate child or unwanted  child or child whose father's paternity is doubled
The precipitating factor is sudden cry, which interferes with either parent in sleep or outing or watching television programs. Battering results due to sudden loss of temper under and allied circumstances...
2. The type of persons involved in battering of children usually having low IQ.
3. Some have a standing emotional problems and financial stress, while others having history of criminal
background.
4. Recent report suggest that such person would have received such treatment from their parents in their own childhood.
INJURIES SUSTAINED:
1. Injuries   commonly are multiple, all are not necessarily severe.
2. Tearing  of frenulum in the upper lips and of alveolar margins of the gums to stifle the cry is commonly encountered
3. Fatal injuries: injuries in head, subdural hematoma or visceral injuries eg: ruptured liver & mesenteric hemorrhage.
4. Clinical and radiological evidence may be obtained that injuries have occurred at different times
DIAGNOSIS OF THE SYNDROME:
5. THE SYNDROME MAY BE CONSIDERED IN ANY CHILD
• In whom the degree and type of  injury is at variance with the history given.
• When injuries are of different ages and in different healing stages.
•  when there is a purposeful delay of seeking medical attention even though the injuries are severe, who exhibits evidence of fracture of any bone, subdural hematoma, failure to thrive, soft tissues swelling  or skin bruising or who dies suddenly.
Medico-Legal Importance:
6. The history may be completely misleading as to the circumstances surrounding death.
7. The external and internal examination should be thorough and supported by photograph,radiograph, microscopic sections of all the persistent lesions and toxicological analysis.
8. In INDIA, it is very rare, as children are considered as gifts from GOD. However instances of ill treatment of young children who work as domestic servants are not uncommon.