My response:
Has anyone ever mentioned the following to you ?
Munchausen syndrome by proxy
Causes and Risks:
This syndrome almost always involves the mother. Symptoms of illness may be mimicked by adding blood to the child's urine or stool, withholding food, falsifying fevers, surreptitiously giving emetics or cathartics to simulate vomiting or diarrhea , or other maneuvers to make the child appear ill. These children are often hospitalized with groupings of symptoms that don't quite fit classical disease findings.
The parent is very helpful in the hospital setting and is appreciated by the nursing staff for the care she gives her child. This behavior makes the child accessible so that the symptoms can be made to persist. Acute changes in physical exam, vital signs , and so on. are never witnessed by hospital staff, but almost always occur in presence of the mother.
Munchausen syndrome is not an intentional type of abuse. It occurs because of psychological problems in the adult, and is generally an attention-seeking behavior. However, the syndrome can be life threatening for the child involved because this unusual behavior can escalate.
Prevention:
Recognition of Munchausen syndrome in the child-parent relationship can prevent continued abuse and unnecessary, expensive and possibly dangerous medical testing.
Symptoms:
Symptoms vary (See the discussion under the Causes section).
Signs and Tests:
symptoms that do not fit a classical picture of illness or do not fit together well
improvement of symptoms on hospitalization with reappearance on return to home
blood in lab specimens that does not match the patient's blood type
evidence of drugs or chemicals in serum, stool, or urine that cannot be accounted for
overattentive, overhelpful behavior of parent, which raises suspicion in face of other findings
Treatment:
Once the syndrome is recognized, the parent needs to be confronted and offered help rather than be accused. Because this is a form of child abuse , the syndrome must be reported to the authorities. Psychiatric counseling will probably be recommended for the parent involved.
Prognosis:
This is often a difficult disorder to treat and often requires years of psychiatric support.
Complications:
Unidentified, Munchausen syndrome by proxy can result in the death of the involved child.