What should you do if you think a child is being abused?

Abuse is best managed by a multi-disciplinary team who have experience with caring for abused children. Always be kind and gentle with the child, and handle the parents with support and understanding. Be non-judgemental and non-threatening as being accused of child abuse is always emotionally threatening. Stay calm and do not become aggressive with the parents. It is often very difficult to tell with certainty whether a child is or is not being abused.

  1. A careful history from the child and family is important. Children rarely lie about abuse.
  2. A full examination looking especially for unusual or unexplained injuries. The examination must not be traumatic for the child. Look for signs of malnutrition or neglect. Has the child been drinking alcohol?
  3. All past and present injuries must be carefully documented. Make good notes as they may be used in court. Always date and sign your notes.
  4. Provide any immediate physical or emotional treatment needed.
  5. Always consider the safety of the child. You may have to remove the child to a safe place until the investigation of child abuse is completed. Never allow a child to be taken home if you suspect that the abuse will be repeated. The safety and interests of the child must always come first.
  6. If at all possible the child and parents should be seen urgently by someone who has had special training in the management of child abuse. Many big hospitals have a child abuse team. If this is not possible, contact an experienced person immediately.

Always examine the fundi of the eyes for retinal haemorrhages which are important indicators of physical abuse.

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