Signs of Munchausen syndrome by proxy include:
- A child who is often hospitalized with unusual and unexplained symptoms that seem to go away when the caregiver is not present
- Symptoms that don't match the child's test results
- Symptoms that worsen at home but improve while the child is under medical care
- Drugs or chemicals in the child's blood or urine
- Siblings of the child who have died under strange circumstances
- A caregiver who is overattentive to the child and overly willing to comply with health care workers
- A caregiver who is a nurse or who works in the health care field
Victims of Munchausen syndrome by proxy have to go through unnecessary tests and treatments that can be painful or even dangerous. Because the caregiver seems so genuinely concerned, it's often hard for doctors to spot the problem before it's too late. This difficulty discerning Munchausen syndrome by proxy from real illness has led to a number of false allegations against parents.
In the 1990s, Dr. David Southall of England conducted an experiment using hidden video surveillance in hospital rooms to catch those suspected of having Munchausen syndrome by proxy. His video cameras captured horrifying images of mothers smothering and poisoning their children. Of the 39 suspected abusers he videotaped, 34 were captured on tape hurting their children and five later admitted to killing their children.
Although Southall was hailed as a champion of children in some circles, he was vilified as an enemy of mothers in others. A number of parents were sent to prison, and some say falsely accused, based on evidence he provided. In 2004, Southall was found guilty of serious professional misconduct after falsely accusing a man of murdering his children, and was temporarily banned from working with child abuse victims.