Child Abuse in Premature Vs Normal Term Infants

By: Iqra Farooquee
Neonatology is a sub-specialty of pediatrics that provide medical care for newborn infants, especially the ill or premature newborn.

Infants and abuse?

As the population increases, the need for neonatal care is also increasing. Infants aren’t able to speak and tell you what they’re symptoms are, which makes this job harder than most. Doctors deal with many issues regarding the causes of the infants’ illness. One of the most problematic reasons can be child abuse.

According to the American society for the positive care of children (SPCC), “In 2015, about one-quarter (24.2 %) of victims are infants” (American 1). There is still speculation in why child abuse is more prevalent in adolescents than any other age but it is being recognized by the doctors who are more likely to report the cases than earlier years. 

 The incidence of child abuse is higher for premature populations than normal term infants as the lack of parent-child bonding, severity and prevalent cases of abuse is higher in premature populations.

Parent-Infant Bonding

    The concept can be broken into four elements: non-accidental physical injury, neglect, sexual abuse, and emotional abuse. (American 2). Parents of these preterm babies encounter unique problems, mostly associated with poorer health of the infants. These problems can increase stress in parents.

There is no excuse or reasonable explanation as to why parents are more likely to abuse their infant at such a young age.

A study showed that the mothers of premature infants reported higher levels of stress during the first year of their infant’s life than did mothers of full-term infants. The findings confirmed that preterm birth has a great influence on maternal emotional responses..

Research by Egeland and Vaughn suggests that,

 “development of an affectionate bond between parent and infant is impeded due to neonatal problems. First, the physical characteristics of premature infants violate parental expectations, because the infants are small, unattractive, and require special care” (Frodi, 19).

Second, unlike parents of full-term infants, parents of preterm infants have to invest more work into their child and get less in return.

Finally, many assume parents do not interact with their child because of the premature infant’s characteristics rather it’s actually stereotyping and parental expectations of pre-maturity that hinders the interaction of a parent-infant bond (Frodi 19). These factors cause a disturbance in parent-infant bonding which subsequently found that infants with lower levels of fetal growth and preterm birth are at increased risk of sexual abuse, physical abuse, emotional abuse, and neglect.

A Typical Abuse case

The parents are suppose to be the most trustworthy, ironically they can also be the problem.

Child abuse has been recognized by the World Health Organization as major health problem, as it impairs the health and welfare of children and adolescents. The exact number of maltreated infants is not more prevalent in recent years, but professionals become more aware of it and are more likely to report cases of maltreatment and neglect.

As such, many cases revolve around abuse before and after being in the ICU and usually the infants are victims of shaking. In one particular case by Dr. Hoffman, a 32-week infant born with respiratory issues (difficulty breathing) was in the ICU for about 2 weeks and after treating her back to health, she was ready to go home with routinely check-ups and a few follow-ups. A few weeks later, and the mother reported that she accidentally dropped the infant who had hit her head on the patio. The infant was taken to a clinic where everything seemed healthy, it was further revealed that family history was positive for a previous death of a 3-day-old infant from sudden infant death syndrome. 

“Documentation from the NICU hospitalization revealed several nonspecific concerns—that the father was uncomfortable handling the infant and had made statements such as “I can’t stand it when she cries.” The mother reported that she sometimes purposely left the infant with the father to help them bond” (Hoffman 3).

The infant then was sent for tests including a CT scan that revealed several damages to the brain and was admitted to the pediatric intensive care unit for ongoing investigation. This case is one of several incidents that have occurred due to a premature birth. Parents are unable to recover quickly from the stress that comes before and after the ICU which is why premature infants are usually victims of abuse. Normal term infants are seen with similar cases as well but aren’t as prominent as preterm infants.

Unfortunately it’s the Pre-term infants


        In conclusion, Birth of preterm infants is a stressful event for their parents where as normal term births are desired. Unlike normal term infants, long term separation and less attractive, less responsive appearance of preterm infants also makes it difficult to build parent-infant relationships. In addition, parents that have to deal with their infants being in the ICU are more likely to experience depression, anxiety, and stress-related disorders. These factors often regarded as a risk factor for child abuse and maltreatment in later life which makes it prevalent among preterm infants than the full term infants. Medical professionals should pay attention to details in family history and parent interaction with their infants, as well as psychological conditions of their parents for the improvement of their mental health.

What parent would want to hurt their baby? The parents mental health is just as important, as long as they are alright, the baby will be too 🙂



Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.