Need to vent - accused of child abuse

[999forever]

Hi all. I’m posting here because I am just going through it right now. Last weekend saw a faint bruise on my 9 month old’s abdomen. I have anxiety and realize I tend to catastrophize everything related to health. I immediately thought this was going to be something bad but instead of panicking, I thought I would text my doctor and ask for her opinion. Baby is acting fine, crawling, learning how to stand and walk, so I am trying to reassure myself and think he bumped it. She texts me back that I need to go to ER to get it checked. I freak.

My husband and I drive straight to ER. They do his blood work, catheter, and look him over. They find a rash on his ear and ask me what that was. I told them I noticed him scratching his ear earlier in the day but didn’t think anything of it since he seemed in good spirits. They say nothing except they want to wait for blood work. Blood work comes in and I am preparing for the worst. Instead, they tell me his white blood cell count is high which is a sign of stress. I’m so confused and just blurt out “is this cancer?” They look at us and tell us the only a enue they are pursuing is abuse. We are shocked. They report us to CPS and we are admitted overnight. They do an ultrasound and X-ray which all came back normal.

The next morning, the doctor comes in and asks to see the bruise. We take off his inside and it’s gone. He says we need to do more blood work, another ultrasound and X-ray. I ask why since the other ultrasound and X-ray came back clear. He says because baby was moving too much and they might need to sedate him. I was so upset and said I didn’t want to do that. After some back and forth, he agrees to start off with just blood work to check white blood cell count. I don’t hear from him again until 6pm. He calls and says he’s too busy to come up but blood work is fine so we can go home.

CPS comes next day and interviews is all and inspects house. I tell her I wfh and my sister watches the baby while I work. She watches him in home and either I or my husband is home 24/7 with her. She’s also watched out two oldest kids. We trust her with everything. Woman leaves and I get a call three hours a later that a CPS doctor wanted him to get a second X-ray. I start to cry. I’ve already missed days of work, fell behind in my projects, have seen my son scream and cry while feeling so helpless. It’s just all so much. I feel like I’m living in a crazy world and it’s surreal. We don’t even yell at the kids. I’m just at a loss. Thank you all for reading this far.

 

[jillian92]

@999forever Big hugs to you mama, this is such a crazy story. You are doing the best for your kiddo and I’m so sorry this is happening. Hopefully it will all be resolved soon.

 

[999forever]

@jillian92 Thank you. I’m more frustrated with our pediatrician than anyone else. I know ER doctors need to be aware of these things but I feel like pediatrician really let us down. I’m still stunned.

 

[debzyj]

@999forever I'm so sorry you're going through this. I'd be so upset with the pediatrician, too. Did you let them know what happened? Why would they think a bruise, absent any other symptoms, was enough of an emergency to go to the ER?

 

[sandramartin01]

@debzyj Wondering this as well. ER visits are extremely costly and that is before the stress of CPS getting involved.

 

[shela710]

@debzyj Because bruising on the abdomen is a very unusual area, and can indicate very serious deeper injury. That’s also why the ER doctors jumped right to multiple imaging modalities instead of being like “yep that’s a bruise alright”. Neither ped or ER did anything inappropriate IMO.

 

[debzyj]

@shela710 Could you elaborate on that a bit? Other than abuse or neglect (or accidental bodily trauma, I suppose), what are other possible causes for bruising in that area? I guess I'm wondering if the pediatrician suspected possible abuse right from the get-go.

 

[shela710]

@debzyj Bruising on abdomen can indicate internal bleeding, concerning in any trauma (including abuse but also falls, auto accidents, etc). I mean of course you can also bruise your abdomen if you bump into the counter and hit your belly hard, but it’s an unusual spot for a bruise in a kid or an adult, usually we’d hit with arms first for example.

 

[brendabree]

@shela710 It's also a really common spot for bruising to show up as a sign of childhood leukemia. Hence the doctors checking white blood cell counts.

 

[debzyj]

@brendabree Oh, wow. That's terrifying to even think about. Also good to know!

 

[debzyj]

@shela710 Oh, that does make sense. Thank you for the explanation!

 

[tmp]

@debzyj I’ve heard the same basically mild head and leg bruises are totally normal /fine and just watching any kid you can come up with a quick simple explanation but to cause abdomen or arms to bruise requires a bit more force and isn’t an easy way they can hurt themselves so it’s abuse red flag.

 

[999forever]

@debzyj She said it was because she thought it could be a liver problem or probable with his spleen.

 

[debzyj]

@999forever Ah, I see. That's so scary to be contemplating at the same time you're dealing with being suspected of abuse. I'm so sorry, and hope things are sorted as quickly as possible.

 

[jdn2604]

@999forever I saw in another comment that you’re aware, but I’ll leave this here for others: bruising on the torso, ears and neck, bruising anywhere on a baby less than 4 months old, bruising on the frenulum, angle of the jaw, cheeks, eyelids, and subconjunctivae, and patterned bruising are all associated with non-accidental trauma and should trigger a thorough examination and concern for child safety (which by law requires a CPS report). Labs and imaging are standard and would provide evidence for/against things like internal bleeding, stress, organ damage, and fractures, and often there is repeat imaging a week or two later that would help to understand the timeline of healing fractures or see evolving evidence of fractures that didn’t show up on the first.

Your pediatrician did the right thing.

That said- it sounds like they (and their staff) didn’t go about it the right way. It should be a conversation about their concerns for your child’s safety, not an accusation directed towards you. The CPS report is filed on behalf of your child, not on/against you.

CPS doesn’t have doctors, at least in my state. Hospitals have child protection teams and your pediatrician may have consulted one; is that who wanted the x-ray? If so, most of those doctors are pediatricians who did a 3-year child abuse pediatrics fellowship focused entirely on recognizing and evaluating safety concerns. You may know with certainty that your child has not been hurt intentionally, but they don’t, and they have seen many many cases where a child comes in with an inconspicuous bruise on the belly and an abrasion on the ear and ends up having 19 fractures in various stages of healing on imaging.

The system absolutely sucks, it’s filled with bias, and the conversations are hard and many generalists are not trained to have them- but every kid like yours that a pediatrician ignores might be a kid who needed someone to speak up.

(I did a rotation with our child protection team in medical school, and I’m working on a project geared towards improving the way we have those conversations).