What would make a mother do this to her son?

Most parents would do anything to protect their children. Go to any lengths to keep them safe, and sacrifice anything if their children were sick.

Which is why stories like that of Lacey Spears, and her son Garnett, are so shocking.

Lacey Spears is a mummy blogger in the US, who has been charged with depraved murder and manslaughter over her five-year-old son’s death. The mother blogged about her son’s battle with illness for many years; prompting sympathy and support from online communities and doctors alike. But when Garnett passed away after being rushed with hospital – and when doctors were not able to identify what was wrong with the little boy – the authorities started investigating.

Ms Spears has since been charged with poisoning her son with salt, through a tube in his stomach – and eventually killing him.

Mamamia previously wrote:

Lacey Spears told friends that Garnett had “failure to thrive” — a catch-all term for children who don’t eat enough and had a feeding tube inserted as a baby. In the first year of his short life Garnett, was in the hospital 23 times, once for five weeks. All these incidences chronicled in detail on social media…

Then, on January 19, five-year-old Garnett was airlifted to hospital.

Lacey’s Facebook page showed heartbreaking images of her little man on life support. She wrote that it appeared to be a stomach virus, but that he battled it bravely. Tragically, he died on January 23rd.

It seemed that suspicion had already begun before his death, with doctors were surprised by the unusually high level of sodium in the five-year-old’s system.

It has been suggested that Ms Spears may suffer from the psychiatric disorder ‘Munchausen by proxy syndrome’.

The more common Munchausen syndrome is when a person fakes an illness in order to get attention; Munchausen by proxy is relatively rare form of child abuse that sees caretakers fabricate or exaggerate illnesses in children to garner sympathy. In Lacey Spears’ case, she was receiving sympathy from her extensive social media networks; on her blog, MySpace, and Twitter.

According to the Medical Journal of Australia, “The label ‘Munchausen by proxy syndrome’ is best applied to cases of child abuse in which a caregiver, usually the child’s mother, fabricates symptoms or induces illness in a dependent child, and the doctor mistakenly believes that a naturally occurring illness is present. Thus, an active interaction between the caregiver-perpetrator and medical professional is required for the syndrome to occur.”

Munchausen by proxy (MBP) is also known as ‘fabricated or induced illness by carers’ (FIIC). The illness in the child is faked by actually harming the child, with the most common forms of abuse being apnoea (stopping the breathing of the child) and poisoning (as in Garnett’s case).

If you still can’t understand how such an illness is possible, the Better Health Channel answered some of our questions.

How common is Munchausen by proxy?

Munchausen by proxy is very rare, with estimates suggesting that there are between 15 and 24 cases identified in Australia every year. It is a syndrome usually associated with mothers, although this may be because women are more likely to take on the role of primary caregiver to children.

What does it look like?

When a person has Munchausen by proxy, there are a number of signs and symptoms. The ‘sick’ child is likely to have an extensive medical history looking for what is wrong, with no conclusive results despite medical investigations.

Children are also likely to have a strange collection of unrelated symptoms, and new symptoms may appear after certain medical tests prove negative. Caregivers may also take the child to visit a number of different doctors, sometimes in different states; and frequently take their child to emergency departments, often at different hospitals.

What are the risks and complications?

There are also serious risks that come with Manchausen by proxy – as Garnett’s death proves. These can include side effects from prescription medicines, complications from poisoning and other forks of harm, or even complications from unneeded medical procedures and surgery that have been performed at the behest of the parent.

Can Munchausen and Munchausen by proxy be treated?

Even diagnosing these syndromes can be difficult, because so many genuine physical (and other mental) illnesses must be ruled out first. Doctors may finally identify the syndrome if the patient’s symptoms don’t make sense when compared to test results; or through more intuitive identification, such as the doctor thinking that the person is unusually eager to have serious surgeries, or finding out that other people in the patient’s life don’t confirm the symptoms.

Unfortunately, recovery for Munchausen and Munchausen by proxy is either slow or non-existent. People with either of these syndromes are unlikely to ever admit to falsifying symptoms – and may even refuse any sort of psychiatric help. Some doctors recommend cognitive behaviour therapy to try and overcome the disorder.

Who can help?

If you are concerned you may know an individual with Munchausen by proxy, you can call these helplines for assistance.

Australian Psychological Association: 1800 333 497

Association for Relatives and Friends of the Mentally Ill: 1300 794 992

Child Protection Crisis Line: 131 278

The most important thing to remember about the syndrome is that it is a serious psychiatric illness – and that the caregiver and the child alike both need help.

Mamamia will keep you updated as the story of Lacey Spears develops.