Health Assessment Of The Toddler, Preschool, And School-Aged Child – NRS-434VN Topic 2 Types of Child Abuse in Infants:

Physical abuse of infants typically involves intentional actions that cause physical harm or injury (Crosson-Tower, 2019). Common signs may include unexplained bruises, burns, fractures, or head injuries. Infants are especially susceptible to abusive head trauma (shaken baby syndrome), which can lead to severe brain injuries. Neglect involves the failure to provide for the infant’s basic needs, such as nutrition, hygiene, and supervision (Crosson-Tower, 2019). Neglected infants may exhibit failure to thrive, malnutrition, dehydration, poor hygiene, and delayed developmental milestones. Emotional abuse in infants is often difficult to detect. It includes actions that harm the infant’s emotional well-being, such as constant criticism, humiliation, or rejection (Crosson-Tower, 2019). Signs may include excessive irritability, poor attachment, and developmental delays. Although relatively rare in infants, sexual abuse can occur. Signs of sexual abuse may include bleeding, discharge, or bruising in the genital area, as well as unusual behavior or regression in developmental milestones (Crosson-Tower, 2019).

Nurses play a crucial role in identifying child abuse. Warning signs and assessment findings in abused infants may include infants who present with unexplained or inconsistent injuries, such as multiple fractures at different stages of healing or bruises in non-ambulatory infants, raise suspicion of abuse. Infants experiencing abuse or neglect may exhibit failure to thrive, characterized by poor weight gain and growth. Infants exposed to abuse may experience developmental delays, including language, motor skills, and social development. Abused infants may display excessive irritability, excessive crying, withdrawal, or difficulty bonding with caregivers. Emotional abuse may manifest as anxious or avoidant behavior, excessive fear, or a lack of emotional responsiveness. Discrepancies in the caregiver’s explanations of injuries or health issues may be indicative of abuse (Crosson-Tower, 2019).

In the United States, reporting suspected child abuse is a legal and ethical duty for healthcare professionals, including nurses (U.S. Department of Health & Human Services, 2019). Reporting mechanisms typically involve contacting the state or local child protective services (CPS) agency. In most states, nurses are mandated reporters, requiring them to report suspicions of child abuse or neglect. Reporting should be done as soon as abuse is suspected, and the nurse should provide detailed information, including the child’s name, age, and address, as well as the nature of the suspected abuse and any evidence available.

There are two key factors that increase the vulnerability of infants to abuse. Infants are entirely dependent on their caregivers for their basic needs, making them vulnerable to abuse or neglect by those responsible for their care (Chaffin, Kelleher, & Hollenberg, 1996). Infants cannot verbally communicate their needs or distress effectively. This communication barrier can delay the identification of abuse, as they cannot articulate their pain or fear (Chaffin et al., 1996).

Cultural variations in health practices can sometimes be misinterpreted as child abuse. For example, some cultures practice coining or cao gio, which involves rubbing a coin or other objects on the skin to alleviate illness symptoms. This practice may lead to bruising or skin marks that could be mistaken for physical abuse. Additionally, cultural variations in feeding practices, such as the timing and types of solid foods introduced, might lead to concerns about neglect or malnutrition.

References:

Crosson-Tower, C. (2019). Understanding Child Abuse and Neglect (10th ed.). Pearson.

U.S. Department of Health & Human Services. (2019). Child Welfare Information Gateway: Mandatory Reporters of Child Abuse and Neglect. https://www.childwelfare.gov/topics/systemwide/laws-policies/statutes/manda/