UK children's hospital study reports surge in domestic child abuse during pandemic

There has been a surge in domestic child abuse during the coronavirus pandemic, suggests the experience of one specialist UK children's hospital.The study was published in the journal Archives of Disease in Childhood.

In just one month, the number of new cases rose by 1493% compared with the same period in the previous three years, pointing to a "silent pandemic" in 2020, suggest the authors.They compared the numbers of new cases of head injury caused by physical abuse among very young children seen between 23 March and 23 April this year and the same period in 2017, 2018, and 2019.

March 23 marked the start of lockdown and a period of national self-isolation in the UK in a bid to curb the spread of SARS-CoV-2, the virus that causes COVID-19 infection.Ten children (six boys and four girls) with suspected abusive head trauma presented for treatment during March-April.

Their ages ranged from 17 days to 13 months old.

This figure compares with an average of 0.67 cases a month for the same period in 2017, 2018, and 2019, representing an increase of 1493% in 2020, say the authors.

The symptoms prompting a hospital visit included colic (persistent crying for no obvious reason) in 5 of the infants; breathing issues (apnoea) and loss of consciousness in 4; seizures in 2; extensive bruising in 5; swollen scalp in 5; and marks caused by repeated picking at the skin (excoriation) in 1 child.The infants were comprehensively assessed.

This included head, spine, and skeletal scans, as well as detailed eye and whole body checks.

The results revealed blood pooling in the brain (subdural haemorrhage) in 6 infants; brain swelling in 4; bruising of the brain tissue (parenchymal contusion) in 4; skull fractures in 4; a bleed on the brain (subarachnoid haemorrhage) in 3; and bone fractures elsewhere in 3 of the infants.The infants' families all lived in areas of significant social and economic deprivation.

And there's a complex interplay between abuse, mental health, substance misuse and socioeconomic factors, the authors point out.Two of the parents had a history of criminal activity; 3 had mental health issues; and 4 had financial worries, factors likely to heighten the risk of abusive behaviour, say the authors.