What to do if a mother is verbally and physically abusing her baby, who has visible bruises on their body?

Reporting Suspected Child Abuse

You must immediately report this case of suspected child abuse to the appropriate authorities. 1, 2 The presence of bruises on a baby's body, combined with the mother's angry and threatening behavior, strongly indicates physical abuse that requires immediate intervention to protect the child.

Assessment of the Situation

The scenario presents several concerning red flags:

• Visible bruises on the baby's body
• Mother displaying anger toward the infant
• Verbal threats being made toward the child
• Inappropriate behavioral response from the mother

According to the American Academy of Pediatrics guidelines, bruising in a non-mobile infant is highly suspicious for abuse 1. The presence of bruises combined with threatening behavior creates an urgent situation requiring immediate action.

Immediate Actions Required

1. Document thoroughly:

   • Record all visible bruises (location, size, shape, color)
   • Document the mother's threatening language and behavior
   • Note any discrepancies between any explanation given and the pattern/severity of injuries 2

2. Ensure immediate safety:

   • Separate the child from the mother if possible
   • Arrange for continuous supervision of the child
   • Provide necessary medical care for any injuries

3. Report to authorities:

   • Contact child protective services/social services immediately
   • Notify your supervisor about the situation
   • Follow your institution's protocol for suspected abuse cases

Medical Evaluation

A comprehensive medical assessment should be conducted:

• Complete physical examination to document all injuries
• Consider skeletal survey for children under 2 years with suspicious bruising 1
• Laboratory evaluation to rule out bleeding disorders that could explain bruising 1, 3
• Screening for other potential injuries (abdominal trauma, head injury) 1

Why Option A (Report to ethical responsible) is the Correct Answer

Reporting to the ethical responsible person/authority is the appropriate first step because:

1. Healthcare providers are mandated reporters of suspected child abuse 4, 5
2. The child's safety must be prioritized over parental rights when abuse is suspected 1, 2
3. Delaying reporting could place the child at risk for further harm 6

Why Option C (Mother has right with her baby) is Incorrect

While parents have rights regarding their children, these rights are not absolute and do not include the right to abuse or harm the child. The American Academy of Pediatrics clearly states that when there are signs of physical abuse, the child's safety takes precedence 1, 2. The presence of bruises on a non-mobile infant combined with threatening behavior constitutes a situation where intervention is necessary to protect the child from harm.

Common Pitfalls to Avoid

• Hesitation to report: Concerns about being wrong or damaging the relationship with the family should not prevent reporting when there are clear signs of abuse 7
• Accepting implausible explanations: Bruises on infants who are not yet mobile are highly suspicious for abuse 1
• Failing to document thoroughly: Detailed documentation is essential for both medical care and potential legal proceedings 2
• Confronting the suspected abuser directly: This may escalate the situation and place the child at greater risk 6

Remember that reporting suspected abuse is not an accusation but rather initiating an assessment process to ensure the child's safety and wellbeing.