By Sir Roy Meadow, Jacqueline Mok, Donna Rosenberg
Baby abuse is unforgivable and this publication pulls no punches in describing what it truly is and displaying the noticeable results. while you are thinking about the care of alternative peoples young children i will suggest it.
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Additional info for ABC of Child Protection
Osteopenia is difficult to assess radiographically because at least 30% of bone mineral must be lost before the radiograph looks abnormal. Wormian bones (small sutural bones in the skull) are an important sign of a congenital cause of increased bone fragility (Fig. 7), although it should be remembered that a few small isolated bones are common in young children and become relevant only when more than 6×4 mm in size, more than 10 in number, and arranged in a mosaic or pavement fashion. When doubt exists, the opinion of a specialist paediatrician or geneticist is helpful.
Usually the child has swallowed little or nothing, and it is a poisoning scare rather than a true poisoning event. 5–4 years (rare in those aged <1 or >5) Any age Presentation Poisoning scare or emergency Unusual symptoms or illnesses Substance Drugs; household or gardening product; berries Usually a prescribed drug No of substances ingested One Sometimes more than one Amount ingested Usually none or little Considerable Symptoms Uncommon Common Severe illness or death Very rare Less rare Preceding unusual illness (factitious) Absent Common No of episodes One; recurrence rare Recurrence common Breastfed infants are occasionally affected by drugs in their mother’s milk.
Indirect ophthalmoscopy may show changes, particularly in the peripheral retina, that cannot be viewed with the direct ophthalmoscope. These findings, including peripheral haemorrhages, may have particular importance in identifying an abused child. Use of the direct ophthalmoscope by the primary care or emergency doctor, however, can be a useful screening test. 5% is preferred). If there is concern about using pupillary reactivity to monitor a child’s neurological status, the cyclopentolate (duration of mydriasis up to one day) may be omitted or one eye can be dilated at a time.