Munchausen by Proxy (MBP) Maltreatment Manifesting as Child Sexual Abuse

* MBP is dangerous. It has been estimated that 6 to 10 percent of MBP victims die. When victims die, it is usually because:

1. The perpetrator goes too far or miscalculates. For example, she smothers the child too long or gives the child too much of a sedating drug such as Phenobarbital.
2. Through false reports or manipulation of lab results or other "objective" information, --the perpetrator gives misleading information to the doctor, and the resulting treatments (such as anesthesia and surgery) lead to complications resulting in death.

In a few cases of MBP, a mother has deliberately killed the child. In these cases, the mothers seem to covet the sympathy that comes with the dying, funeral, and other bereavement activities.

* MBP is a recognized kind of maltreatment (abuse/neglect). There are now hundreds of published reports of MBP from around the world. They prove that MBP is not simply a "theory," but that it is a specific form of maltreatment that is of international dimensions. Several books devoted to the topic have appeared in recent years. Most not only summarize the professional literature, but present important new perspectives and recommendations. Though MBP is clearly recognized as a kind of child maltreatment, the American Psychiatric Association is currently studying whether or not it constitutes a formal mental health diagnosis. MBP, under the term "Factitious Disorder by Proxy" is included in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) only as a suggestion for further study.

*MBP perpetrators deliberately engage in MBP behavior. Perpetrators usually carefully plan out the ways in which they will create the appearance of having a child with "problems" and the stories they will tell to conceal their deceptions. They consciously engage in improper behavior and know right from wrong.