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Munchausen by Proxy in Child Custody

Carolyn Woodruff

Dear Carolyn,
I have a strange question for you Carolyn. In fact, it is almost unbelievable. My ex-wife and the mother of my precious child constantly fabricates that the child is ill. The child is constantly taken to the doctor with the Mother saying that the child had a fever “last night.” The doctor cannot find a fever. Once the Mother said the child had blood in her urine, and the child had to undergo all these tests and nothing was found. The Mother tried to have the tonsils taken out indicating medical problems that did not exist. The list could go on for the whole page, but I’ll spare further details. The Mother is a nurse, and I don’t understand why she is getting all the medical items regarding my child wrong all the time. I was in a divorce therapy class and someone piped up when I mentioned this: “does she have Munchausen Syndrome by Proxy?” This Mother thrives on the attention she (the Mother) gets when our child is sick.

Signed: Crazy, isn’t it?

Dear Crazy, isn’t it? 
Yes, it might just be.

First, I am a family lawyer, not a psychologist or psychiatrist, so I certainly cannot make a diagnosis. Second, you described a very serious scenario for your child. If your ex has Munchausen Syndrome by Proxy, your child is being abused and is in serious trouble.

Munchausen Syndrome by Proxy is a parent (often the Mother) who systematically fabricates information about a child’s health or even intentionally makes the child gravely ill (e.g., intentionally putting an infection in an intravenous line). It is a form of child abuse with the perpetrator being the adult and the child being the victim. These adults are seriously mentally ill, and they may falsify medical history, medical test results, or symptoms of the child to meet their own self-serving psychological needs. They may falsify medical specimens. For example, the Mother might say the child is constipated, when the child is not and then give large doses (even of prescriptions) to treat the constipation. We all know where this goes.

They frequently act like devoted parents. Typically, they are well-versed in medical procedures and may have positions in a medical field.

The severity of Munchausen Syndrome by Proxy varies from Perpetrator to Perpetrator, but one really never knows what will happen next. Occasionally, in contested custody, you see elements or facts that might suggest Munchausen Syndrome by Proxy, but the facts fall short of a diagnosis of Munchausen.

You do not say how old the child is, but many child victims are under four years old. Six percent die and 7.3 percent of children have long-term or permanent injuries before the parent is detected. When the victims were detected, 25 percent of the victim’s known siblings were dead and 61.3 percent of known siblings had illnesses similar to the symptoms of the victim. See Psychological Experts in Divorce Actions, Fourth Edition by Marc J. Ackerman and Andrew W. Kane.

The child victim may even go to the defense of the abusive parent when the allegations are first made, as the abusing parent is highly focused.

So, what do you do to protect your child? First, you need to gather all the medical records for your child. Then, armed with your diary of facts and the records, discuss the records with your attorney. You need to write down everything you know or think you know about the medical issues with your child. You will want to ask the court to do a (1) child custody evaluation; and (2) an independent psychological work up of your ex that can lead to a diagnosis, which a child custody evaluation cannot. Since this is abuse, I would be remiss not to advise you to call the Department of Social Services.

You will want to ask for the sole right to make any medical decisions. Quite frankly, this mental disorder is not easily treatable as I understand it, and this Mother may need supervised visitation.

Please keep me posted as I am sure our readers will want to know that the child is alright.

Have a family law question?

Send your questions to Ask Carolyn through our website, on social media, by email at, or mail them to P.O. Box 9023, Greensboro, NC 27427. Please do not put identifying information in your questions.

Note that the answers in “Ask Carolyn” are intended to provide general legal information, and the answers are not specific legal advice for your situation. The column also uses hypothetical questions. A subtle fact in your unique case may determine the legal advice you need in your unique case. Also, please note that you are not creating an attorney-client relationship with Carolyn J. Woodruff by writing or having your question answered by “Ask Carolyn.”

This blog is revised from a previous Ask Carolyn published in the Rhino Times. 

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