Head trauma during lockdown, hospital reports show

A specialist children’s hospital has seen an increase in the number of babies treated for head injuries thought to be caused by abuse, leading experts to warn the medical community that it must stay alert to this ”more silent pandemic” during the coronavirus crisis.

Great Ormond Street Hospital in London treated 10 babies, aged between 17 days and 13 months old, for head trauma which was consistent with abuse between 23 March and 23 April this year, according to a letter to a medical journal.

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This figure is significantly higher than the average 0.67 cases per month that the hospital typically treats over the same period, based on data from the last three years.

Writing in the Archives of Disease in Childhood, the authors of the letter say that the scale of the problem is probably larger than the figures from the first month of lockdown suggest, given that people avoided hospitals at the time over fears of contracting Covid-19.

In the letter, they write: ”This sobering figure is likely under-represented due to public avoidance of hospitals at this time. Notably two parents in our cohort cited fears of contracting SARS-CoV-2 as a reason for delayed presentation.”

“Hence, in the background of the intensely public SARS-CoV-2 pandemic, a more silent pandemic is occurring, of which the medical community must remain astutely aware,” they added.

When the babies arrived in hospital, the six boys and four girls displayed symptoms including extensive bruising, loss of consciousness and breathing problems.

Scans and body checks showed that six of them suffered from blood pooling in the brain, while four had brain swelling, bruising of the brain tissue and skull fractures.

According to the authors, the babies’ families were all from socially and economically deprived areas, with many of them displaying factors likely to increase the risk of abusive behaviour such as mental health problems and financial worries.

Dr Alison Steele, officer for child protection at the Royal College of Paediatrics and Child Health, said the report was “extremely concerning”.

“It is important to find out if the huge rise in suspected non-accidental head injury reported at this specialist hospital is being seen by other hospitals across the country,” she said.

Dr Steele also expressed concern for children whose physical injuries or other forms of abuse can be more easily hidden.

Helen Westerman, head of local campaigns for the NSPCC, said: “This report is incredibly worrying and upsetting. Babies are the most vulnerable people in our society and must always be treated with love and care.

“Our own research of lockdown shows that isolation, a lack of support services including face-to-face meetings with health visitors or mid wives, and the burden of juggling responsibilities between work and family has placed some parents under huge pressure that can increase the risk of physical abuse in the home,” she added.

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