Despite signs and symptoms that are not consistent or that are
ambiguous, or despite surgical procedures and medications that do
not change the reported symptoms, the pediatrician is so
often taken in that they disregard the suspicions of others and
prolong the child’s suffering. Death rates in reported
cases are between 6% and 9%. When a new case occurs,
other siblings who died mysteriously may be discovered.2 In
a study with covert video surveillance of 38 women and one father
suspected of suffocating their children, 33 were observed abusing their
child on camera, and 3 others later admitted abuse. Eventually,
38 out of 39 parents were found to have abused their children. Among
the 42 siblings of these children, 12 died previously from suspicious
causes, 11 were classified as sudden infant death syndrome, and
4 parents admitted to killing 8 siblings of the index children.
An additional 15 were abused.6 The abuse in factitious
disorder by proxy persists for an average of 14 to 22 months before
a diagnosis is typically established.7,8