Carers urged to ask about child injuries

The call was made by Richard Green, NSPCC senior consultant and the co-author of a report on infant protection published earlier this week. The NSPCC report, What Really Happened?, was launched on Monday in Denver, Colorado, at an international conference on child abuse and neglect.

Mr Green, who is a qualified social worker and family therapist, said all childcare professionals have a particular role to play in looking out for signs of child abuse. He said, 'The majority of cases in this report had some injury that had been seen by someone at some point.

'It is important to note, however, that not all minor injuries are signs of abuse, but we would hope that carers would at least be alert to the possibility and ask the parents what had happened.'

The report is the first comprehensive research in the UK to look at cases where babies were seriously injured or died from abuse at the hands of their parents or carers, and where parents' explanations for the injuries were either lacking or inconsistent. These are referred to as SIDE cases - Serious Injuries, Discrepant Explanations - and the report said their defining characteristic is 'the nature of parent/carer explanations which are absent, inconsistent, implausible or discrepant with expert medical or forensic opinion'.

The report examined clinical assessments of 21 cases of serious injuries to babies, and 17 serious case reviews of baby deaths, all of which were SIDE cases that took place over a 20-year period. The most common explanation of an injury given was that the child 'had suddenly become seriously unwell', followed by inadvertent acts by parents such as accidentally dropping the baby while it was being passed between them. Others blamed self-inflicted accidents including 'doing acrobatics' in the cot.

The report added, 'In a small number of cases, parents stated that a boisterous elder sibling must have caused the injuries. One remarkable case involved a grandmother who threw the child protection system into confusion by suddenly asserting in the middle of a child protection conference that she had caused the injuries inadvertently. This was subsequently discounted as not being physically possible in the manner described, and amounted to an unusual false confession (presumably to distract the focus of suspicion).'

Mr Green said, 'We're at great pains to say in this book that good practice has prevented children from dying.' He added that carers should not be afraid to enquire of the parent how their child acquired a bruise, as there could be a perfectly innocent explanation.

Professor Jo Sibert of the University of Wales College of Medicine said in the report that 'present guidelines may result in too much emphasis on working with parents and not enough on the safety of children'. He added, 'We must do better.'

The report costs 15 (inc p&p) from the NSPCC Publications and Information Unit, Weston House, 42 Curtain Rd, London EC2A 3NH (020 7825 2775).