What is Medical Child Abuse?

According to Dr. Thomas Roesler, MD, a child and adolescent psychiatry expert who specializes in Medical Child Abuse:

Medical child abuse (MCA) is defined as a child receiving unnecessary and harmful or potentially harmful medical care at the instigation of a caretaker. Previous names for this type of child maltreatment include Munchausen syndrome by proxy, factitious disorder by proxy, pediatric condition falsification, and fabricated or induced illness by a carer.


In this form of child abuse a caretaker, most commonly a mother, engages in a pattern of behavior that results in medical care providers giving care that the child does not need and which is or could be harmful. [1]

How does Medical Child Abuse relate to chronic Lyme?

According to the American Academy of Pediatrics, “‘Chronic Lyme disease’ is not a medical diagnosis.”

Medical professionals are worried about fake diagnoses and unnecessary treatments given to children, especially in the context of “chronic Lyme disease”.  Health Protection Agency of the UK warned:

  • Children misdiagnosed with “chronic Lyme disease” are a particularly vulnerable group, and one of the references cited by the ILADS guidelines authors [2] illustrated the dangers of misdiagnosis and gross and painful mistreatment.
  • Experience from other clinicians has indicated that some children diagnosed as having “chronic Lyme disease” according to the ILADS criteria received oral and parenteral antibiotics for years, and had unnecessary interruption of schooling and social development, to the extent that there has been a loss of childhood.
  • Serious physical harm to children from adverse events related to overuse of broad spectrum antibiotics for unsubstantiated Lyme disease has also been well-documented. [3]

Dr. Roesler, together with pediatrician Dr. Carole Jenny, MD, MBA wrote about two disturbing instances of apparent Medical Child Abuse in their book Medical Child Abuse: Beyond Munchausen Syndrome by Proxy [4].  Please read the excerpt.

In response to the proposal of the now-passed Massachusetts law that requires insurance companies to pay for unnecessary antibiotics for presumed Lyme disease, pediatric infectious disease specialist and Assistant Professor of Pediatrics Dr. Christina Hermos, MD wrote:

Those of us in pediatrics have the extra burden of witnessing children subjected to unnecessary long-term antibiotics. These children often have other medical or psychological conditions that are left untreated due to an unnecessary focus on Lyme disease.

When they do not recover on antibiotics for Lyme, typically an alternative antibiotic is prescribed rather than an alternative diagnosis explored. When I care for these children as part of my practice, I see parents have significant difficulty accepting that their children’s symptoms are not from Lyme, because they have so much hope that treating this infection will cure their persistent symptoms.

I find this situation especially difficult because there are many resources and other treatment options that I can recommend for these children that would likely help them. [5]

See also: ILADS doctor says a boy is harmed by Wi-Fi, so the parents sued the school.


1. Clinical Advisor: Medical Child Abuse (Munchausen by proxy)

2. Intramuscular Bicillin For Persistent Pediatric Lyme Disease

3. Ettestad et al. Biliary complications in the treatment of unsubstantiated Lyme disease, 1995.

4. Medical Child Abuse: Beyond Munchausen Syndrome by Proxy (Excerpt, Amazon, WorldCat)

5. Letters from Christina Hermos, MD and other medical professionals in response to the 2016 insurance mandate

6. The Scientific Parent: When Seeking Treatment For A Child Crosses the Line: How to Recognize Medical Child Abuse (Part One)

7. The Scientific Parent: When Seeking Treatment For A Child Crosses the Line: Medical Child Abuse Vs. Rare Diseases (Part Two)

8. Teenage Boy With Multiple Pain Disorders: A case of mild factitious disorder by proxy