The ugly truth, too many children are abused in America yearly. According to the US department of health and human services administration for children and families, each year in the United States, Child Protective Service (CPS) agencies investigate more than 2 million reports of suspected child maltreatment, 18% of which involve concerns of physical abuse (Christian & Committee On Child Abuse And Neglect, 2015). Infants age 0-1 years old are more likely to be physically abused because of their vulnerability. They are not able to speak about the abuse or troubles they face because of their age. This also, unfortunately, leads to infants have increased morbidity and mortality with physical abuse according to WHO (Gonzalez, 2020). Some types of abuse infants face are shaking, burning, biting, rib fractures.

Assessment is imperative when identifying these signs of abuse in infants. Continuous crying can be a sign of abuse especially when the infant is touched where the abuse likely occurred. Nurses should be aware of symptoms of shaken baby syndrome which include mild symptoms like vomiting and severe symptoms like lethargy, seizures, apnea, or even coma. Signs of neglect can also suggest that an infant is being abused, for example, malnutrition severe weight loss, or growth failure. Severe diaper rash, untreated dermatitis can be a sign that the caregiver is neglecting the infants’ basic needs. While the nurse is reporting signs of maltreatment or abuse to the caregiver their attitude can tell if they are aware or not aware or they are indifferent to the abuse.

Culture plays an important role when assessing any situation in health care. Some cultural practices can be confused for child abuse. Coining or caogi is an ancient healing practice practiced by Vietnamese, Cambodians, and Laotians. This practice involves rubbing of the skin. According to some, the wind can invade the body and cause a variety of illnesses including headaches, muscle aches, coughs, fevers, upper respiratory infections, and sore throats. To alleviate the symptoms of these illnesses, the forces are balanced by using herbal remedies and dermabrasion. Ointment or oil is applied to the skin and intensive rubbing takes place (Killion, 1970). These rubbings can cause bruises caused by the friction and scars on lighter skin which may seem like the infant is being abused. The nurse must differentiate between cultural practices or abuse.

When child abuse is suspected in Maryland citizens not only nurses should report suspected abuse past or present to the local department of social services or the local law enforcement agency. Healthcare workers are required by law to report suspected abuse orally and in writing. Oral reports should be made immediately while written reports should be submitted within 48hrs. Reporting suspected abuse information can be found on https://dhs.maryland.gov/child-protective-services/reporting-suspected-child-abuse-or-neglect/. Reporting infant abuse can save a life.

Christian, C., & Committee On Child Abuse And Neglect. (2015, May 01). The Evaluation of Suspected Child Physical Abuse. Retrieved January 21, 2021, from https://pediatrics.aappublications.org/content/135/5/e1337?utm_medium=referral&utm_source=r360#ref-1

Gonzalez, D. (2020, November 21). Child Abuse and Neglect. Retrieved January 21, 2021, from https://www.ncbi.nlm.nih.gov/books/NBK459146/

Killion, C. (1970, January 01). [PDF] Cultural Healing Practices that Mimic Child Abuse: Semantic Scholar. Retrieved January 21, 2021, from https://www.semanticscholar.org/paper/Cultural-Healing-Practices-that-Mimic-Child-Abuse-Killion/2be95316f14a8f0f36e441faa2c6777a3c4d60ab