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Published on: February 23, 2024
Pattern of burns in child abuse
Peter Ojo1, John Palmer, Richard Garvey
1Department of Surgery, Hospital of Saint Raphael, New Haven, Connecticut 06511, USA.
Insights
Child abuse burns are under-reported. This study identified specific indicators, like tap water scalds on the left extremity in children under two, to help clinicians identify abuse more effectively.
Area of Science:
- Pediatric burn injuries
- Child abuse and neglect
- Forensic pediatrics
Background:
- Child abuse resulting in burns is frequently under-reported and difficult to substantiate.
- Accurate identification of abuse-related burns is crucial for child protection.
Purpose of the Study:
- To retrospectively analyze burn cases in young children admitted to a burn center.
- To identify patterns and specific characteristics of burns resulting from child abuse.
- To provide clinical indicators for suspected child abuse.
Main Methods:
- Retrospective review of pediatric burn admissions (children < 6 years) over an 8-year period (1997-2003).
- Analysis of burn etiology, injury patterns, patient demographics, and perpetrator information.
- Comparison of accidental versus abuse-related burn characteristics.
Main Results:
- Only 3.8% of 155 burn admissions in children under 6 were confirmed as abuse.
- Tap water scalds were the most common cause for both accidental and abuse burns.
- Abuse burns predominantly affected children under 2, often involving the left extremity, and perpetrators were consistently the mother's boyfriend.
Conclusions:
- Specific burn characteristics, including tap water scalds on the left extremity in children under two years old in the care of a mother's boyfriend, should raise clinical suspicion for child abuse.
- Clinicians should actively investigate potential abuse in such cases.
- Early identification and intervention are critical for child welfare.
Abstract:
Cases of burns from child abuse are low because of under-reporting, low index of suspicion, or lack of verity proof. Although the reported incidence of child abuse by burns is 4 to 39 per cent, less than one-half are substantiated. We retrospectively reviewed all burns in children less than 6 years old admitted to our burn center within an 8-year period (1997-2003). Of the 155 children less than 6 years old admitted with burns within the study period, only six cases (3.8%) were confirmed as occurring from abuse. Scald injury was the most common cause of accidental and abuse burns. Burns by child abuse occur mostly from tap water (50%) and usually in children less than 2 years old. Whenever the extremities were involved, the left side was always included. In extreme cases, however, multiple areas of the body were involved with intervening spared sites. The perpetrator was the mother's boyfriend in all cases. Burns in children less than 2 years old left in the care of the mother's boyfriend, involving the left extremity (or extremities), and caused by tap water should prompt the clinician to more actively confirm or exclude abuse.
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