PHYSICAL NEGLECT: LACK OF CHILD CARE AND NUTRITION
Updated: May 26
Author: Harshita Kapoor, II Year of LL.B from City Academy Law College, University of Lucknow.
Co-author: Adarsh Kumar, V year of B.A.,LL.B(Hons) from City Academy Law College, University of Lucknow.
Child neglect is a form of child abuse and is a deficit in meeting a child's basic needs, including the failure to provide adequate supervision, health care, clothing, or housing, as well as other physical, emotional, social, educational, and safety needs. All societies have established that there are necessary behaviors a caregiver must provide for a child to develop physically, socially, and emotionally. Causes of neglect may result from several parenting problems including mental disorders, unplanned pregnancy, substance abuse, unemployment, over employment, domestic violence, and, in special cases, poverty. Child neglect depends on how a child and society perceive the parents' behavior; it is not how parents believe they are behaving toward their child. Parental failure to provide for a child, when options are available, is different from failure to provide when options are not available. Poverty and the lack of resources are often contributing factors and can prevent parents from meeting their children's needs when they otherwise would. The circumstances and intentionality must be examined before defining behavior as neglectful.
Keywords: Child, Neglect, Physical, Parent, Nutrition, Caregiver
Explicitly, the birth giver upholds the responsibility of the child morally as well as physically. Physical duty almost terminates after a fixed period, but moral duty lasts till the survival of the birth giver. The physical, social, and Emotional Development of the child are established by society. It is a negligent treatment or the maltreatment of a child by the caretaker who is responsible for the child's welfare via actions and duties.
Neglect can be dominant in any of the forms such as general, severe, and physical. General neglect comprises the failure to provide adequate food, clothing, supervision, medical care. Severe neglect comprises the failure of malnutrition, failure to thrive, refusal to seek medical care as well as chronic neglect. But the physical neglect is one of the most prominent neglects among these neglects, including educational and emotional neglects too. Physical neglect generally can be termed a refusal or delay in seeking health care.
Neglect is a failure to provide adequate support, supervision, nutrition, medical, dental, or surgical care. Nutritional neglect is considered an abusive act of omission rather than one of commissions. CHILD MALTREATMENT has some unique characteristics and requires individual approaches to diagnosis and management.
In 2003, the USA Department of Health and Human Service (USDHHS) reported that there were almost 9 lakh children maltreated in the USA. The percentage of "experienced neglect" children is 61 percent. Also, an estimated 1500 children died from physical injuries associated with child maltreatment, 36 percent of these deaths were due to neglect. In developing countries such as INDIA, a new epidemiological method estimates the percentage of child deaths which would be attributed to the potentiating effects of malnutrition in infectious diseases. The results from 53 developing countries with nationally representative data on weight-for-age indicate that 56% of child deaths were attributable to malnutrition's potentiating effects and 83% of these were attributable to mild-to-moderate as opposed to severe malnutrition.
EXAMPLES OF PHYSICAL NEGLECT
Inadequate feeding of child:
Unavailability of food.
Food being withheld intentionally.
Children complaining of hunger.
Children are bound to beg and steal food.
Inadequacy of shelter:
Unsanitary condition (Garbage, excrement, spoiled food)
Homelessness is the major risk factor that is dominant.
Lack of supervision:
Children are left in the care of children who are unable to take care of them.
Exodus issues should be referred to the school district.
Inadequacy of clothing and personal hygiene:
Inappropriate and lack of clothes for a particular weather.
Persistent skin disorder or severe diaper rash due to improper hygiene.
Lack of medical and dental care:
Failure of medical treatment leads to the risk of child death.
Lack of attention to severe dental problems.
Failure to protect:
Failure of the parent or caretaker to protect the child from a known situation of various child abuse.
EFFECTS OF CHILD NOURISHMENT
Physical neglect can have prominent and long-lasting impacts on a child's health and well-being existence. Failure to thrive, malnutrition, severe dehydration, ongoing and untreated illness, and exposure to harm due to being unsupervised are all examples of the consequences of physical neglect. Moreover, lasting emotional and psychological consequences have an effect on the child for the entire life in the form of low self-esteem, which results in substance abuse, promiscuity, and self-destructive behavior as the child ages forward.
Children often neglected catch depression, anxiety, and mental health disorder as they age forward. They are also considered to be more prone to violent behavior and criminal activity.
CONSEQUENCES OF NEGLECTING A CHILD
A person with suspicious aspects of neglecting a child likely faces an investigation by CPS or police or both. Criminal charges against the accused can also be forwarded if the prosecutor believes that there is enough evidence of a crime. If the investigation is carried out by CPS and the agency believes that there is enough evidence to support a claim of neglect, a petition will be filled in the family court, which may result in permanent or temporary loss of custody. The consequences of the investigation can be devastating and traumatic for both parents and children. As they have rewarded prison time or loss of custody over their children.
Attorneys in different parts of India with huge experiences are defending those who are being falsely accused of abusing and neglecting children. For decades the attorneys at The Kronzok Firm are skilled abused or neglect attorneys. Family law attorneys and Criminal Law attorneys both are equally valuable in such cases. Whether the investigation is conducted by CPS or the police attorneys, can go through every aspect of the case representing the accused in family court or criminal court or both, depending upon the specification of the case.
One of the most uncontested phrases of life is parenting, which can cause anger and frustration in the most even-tempered parents. If you are brought up in a household where the environment was embraced with screaming, shouting, or violence, you may not be familiar with the way children are raised. Recognizing that you have a problem is the biggest step to getting help.
The following are the warning signs that you may be crossing the line into neglect:
You can’t control your anger – What starts as a swat on the backside may turn into multiple hits getting harder and harder. You may neglect your child more and more and finally throw them down.
You feel emotionally disconnected from your child – You may feel so overwhelmed that you don't want to do anything with your child. You just want to be left alone and for your child to be quiet.
Meeting the daily needs of your child seems impossible – If every parent battles with maintaining the balance between dressing, feeding, getting kids to their schools or other activities, but on the other hand, you are almost far behind to tackle these things, this delineates that something is wrong with you.
ROLE OF CARE
The role of care in child nutrition is often neglected. Care comprises actions and deeds promoting survival, growth, and development, involving household food security and health-promoting behavior. Availability of resources for care includes income, food, time, attitudes, relationships, and knowledge. Emotional and affectionate care has direct impacts on child survival, growth, and development.
At least, 7% of the children in all countries on go some sort of disability, but for the fact that only 2-3% of them are considered disabled by the community. Nutrition can do much to prevent disabilities and ensure that the disabled child is not a liability.
THE ASSOCIATION BETWEEN OBESITY IN ADULTHOOD AND NEGLECT IN CHILDHOOD
As per recent studies, obesity in adulthood has a clear association with child neglect. Parental neglect greatly increased the risk in comparison with harmonious support. Dirty and neglected children had a much greater risk of adult obesity than averagely groomed children. Parental neglect during childhood predicts a great risk of obesity in young adulthood, independent of age and body-mass index in childhood, sex, and social background.
Nutritional neglect causes stress to children, and they respond to it by increasing food intake or by decreasing activity. Certain studies show that childhood maltreatment is a well-established risk factor for later depression and anxiety. Child maltreatment gives way for mental disorders, mood, and anxiety disorders to rise and dominate. A child aged 3 years has a great risk of obesity if he/she has experienced neglect in the prior years.
CONSEQUENCES OF NUTRITIONAL NEGLECT ON THE ORAL HEALTH OF CHILDREN
Dental neglect, as defined by the American Academy of Pediatric Dentistry, is the "willful failure of a parent or guardian to seek and follow through with treatment necessary to ensure a level of oral health essential for adequate function and freedom from pain and infection." Dental caries, periodontal diseases, and other oral conditions, if left untreated, can lead to pain, infection, and loss of several functions. These pessimistic outcomes have a wide range of adverse effects on learning, communication, nutrition, and other activities which are mandatory for normal growth and development. Failure of dental care or maintenance of oral health usually rises from factors such as family isolation, financial issues, parental ignorance, or lack of perceived value of oral health. The time from which parent negligence is considered and starts being intervened gradually occurs after the parent has been properly alerted by a health care professional about the nature and extent of the child's condition, the specific treatment needed, and the mechanism of accessing that treatment. It is the prior duty of a physician or a dentist to make sure the caregivers about the oral disease and its implications, and when the caregivers encounter any hurdles in assisting care like searching financial aid, transportation, public faculties or some other services, they should make attempts to assist their needs.
NUTRITIONAL NEGLECT IN CHILDREN OF ALCOHOLICS
Alcoholics, like all the addicted, face their pain and problems due to which they have little time and energy left to spare for their children's care. The economy is a field that has to be organized in ordering a family to be viable and useful in a community. Drinking habits add to the economic burdens for the family's welfare, including basic nutritional needs.
Children need emotional and physical support as their strength which is needed to be fulfilled through parental handling from the earliest months of life. Parent-child attachment relies on several factors. Any inconsistency, in appropriation or punitive actions from parallel sides, can rupture these attachments. Neglect from alcoholic parents during childhood may be a potential interactive factor in the development of antisocial behavior.
SOCIAL ASPECTS ABOUT DEATHS FROM NUTRITIONAL NEGLIGENCE
The number of unreported cases of neglected children is much higher than that of the physical ill-treatment of children. When nutritional neglect was traced, physical ill-treatment was proven at the same time. Symptomatic is, in the first place, intense emaciation as well as dry puckered, scaly, and extremely dirty skin, lack of subcutaneous fatty tissue and Bichat's fat pad, matted hair, aged face, sunken eyes, and eczema from urine with ulcerations in the buttock and thigh regions. Some more common facts which supported the deaths from nutritional neglect are extremely bad social conditions, severe poor parents, and extremely backward social background.
The young age of the mother in combination with the low economic situation leads more often to negligence. Alcoholic fathers, often at a young age, unwilling to work, found it difficult to care for their family. Realizing the significance of the early development of a child for its later social attitude, mothers with all their problems and responsibilities should not be left alone to their way. Motherly behavior is not inbuilt by default from the birth of the child. Mother duties should be learned as early as possible, and this process begins during pregnancy at the latest.
Prevention from child neglect is not an optimistic indication that parents are doing a great job, but it signifies that they are creating an atmosphere where doing a great job is easier. Physical neglect of a child is a serious threat to the healthy development of children. Moreover, a consistent lack of attention to care and supervision is provisionally unacceptable. Individuals must enhance the ability to accept personal responsibility to reduce child neglect by assisting support to each other and offering their patronage to the children along with their family and community.
Malnutrition and obesity are phenomenons that are widely accepted as an act of nutritional neglect. Even today, nutritional neglect that leads to malnutrition and obesity occurs even in families with loving parents or in medical facilities by caring medical staff. Pediatricians, dentists, general doctors, and nutritionists should be aware that the ultimate stage of nutritional neglect may lead to death.
1. Herschaft Ε. Alder M., Ord D., Rawson R., Smith E. Manual of forensic odontology, ASFO, Impress Printing & Graphics, Inc. New York. 2006; 210-240.
2. Pelletier DL, Frongillo EA Jr, Schroeder DG, Habicht JR. The effects of malnutrition on child mortality in developing countries. Bull World Health Organisation.1995; 73(4):4438.
3. www. safe child.org.16/02/09.
4. Longhurst R, Tomkins A. The role of care in nutrition-a neglected essential ingredient. SCN News, 1995; (12):1-5.
5. Golden H M, Samuels PM, Southall PD. The conundrum of child malnutrition with loving and caring parents. Archives of Disease in Childhood.BMJ Publishing Group & Royal College of Pediatrics and Child Health. 2003; 88:105-107.
6. Lissau I, Sorensen TI. Parental neglect during childhood and increased risk of obesity in young adulthood. Lancet.1994; Feb 5; 343(8893):324-7.
7. Steptoe A, Wardle J, Polland TM, Canaan L, Davies GJ. Stress, social support, and health-related behavior: a study of smoking, alcohol consumption and physical exercise. J Psychosom Res.1996 Aug; 41(2):171-80.
8. Oakley Browne MA, Joyce PR, Wells JE, Bushnell JA, Hornblow AR. Disruptions in childhood parental care as risk factors for major depression in adult women. Aust N Z J Psychiatry.1995 Sep; 29(3):437-48.
9. Anderson SE, Cohen P, Naumova EN, Must A. Relationship of childhood behavior, disorders to weight gain from childhood into adulthood. Ambul Pediatr.2006 Sep-Oct; 6(5):297-301.
10. Nemeroff CB. Neurobiological consequences of childhood trauma. J Clin Psychiatry.2004; 65 Suppl, 1:18-28.
11. Kessler RC, Davis CG, Kendler KS. Childhood adversity and adult psychiatric disorder in the US National Comorbidity Survey. Psychol Med.1997 Sep; 27(5):1101-19.
12. Faith MS, Matz PE, Jorge MA. Obesity and depression associations in the population. J Psychosom Re.2002 Oct; 53(4):935-42.
13. Whitacker RC, Phillips SM, Orzol SM, Burdette HL. The Association between maltreatment and obesity among preschool children. Child Abuse Negl.2007 Nov-Dec; 31(11-12): 1187-99.
14. www.ScienceDaily.Com.Higher Risk of Obesity for Children Neglected by Parents.16/11/2007.
15. Varness T., Allen B.D., Carrel L A., Fost N. Childhood Obesity and Medical Neglect. Pediatrics: 2009; Jan 123(1):399-406.
16. www.news.bbc.co.uk/go/pr/fr/-/2/hi/health/6749037.stm.Publ. 2007/06/14, 04:17:54, GTM.
17. Alexander SM., Baur LA, Magnusson R, Tobin B. When does severe childhood obesity become a child protection issue? Med J Aust.2009; Feb 2: 190(3): 136-9.
18. American Academy of Pediatric Dentistry: Committee on Child Abuse and Neglect. Guideline on oral and dental aspects of child abuse and neglect. Pediatric Dentistry, 2005; 27(7):64-67.
19. Rao K N., Begum Sh., Gangadharappa N. Nutritional Neglect and Physical Abuse in Children of Alcoholics. Indian J Pediatr. 2001; Sept 68(9):843-5.
20. Trube-Becker E. The death of children following negligence: social aspects. Forensic Sc.1977; Mar-Apr 9(2):111-5.
21. www. World Health Organisation.org. 22/02/09.
22. Cheyne VD: Dental care during the period from birth through two years. J Dent Child, 1947; 14: 2-5.
23. Taylor J., Daniel Br. Child Neglect: Practice Issue for Health and Social Care, Jessica Kingsley Pub., 2004; pp.26-352.
24. Loochtan R„ Domoto N. Dental neglect in children: definition, legal aspects, and challenges. Pediatric dentistry, 1986; 8:113.
25. California Society of Pediatric Dentists. Denial Neglect: When to report. Calif. Pediatrician, 1989; Fall: 31-2.
26. Wing RR, Greeno CG. Behavioral and psychosocial aspects of obesity and its treatment. Baillieres Clin Endocrinal Metab.1994 Jul; 8(3):689-703.
27. Greeno CG, Wing RR. Stress-induced eating. Psychol Bull.1994 May; 115(3):444-64.
28. Oakley Browne Ma, Joyce PR, Wells JE, Bushnell JA, Hornblow AR. A troubled youth: relations with somatization depression and anxiety in childhood. Fam Pract.1996 Feb; 13(1):1-11.
29. Anderson SE, Cohen P, Naumova EN, Must A. Association of depression and anxiety disorders with weight change in a prospective community-based study of children followed up into adulthood. Arch.Pediatr Adolsc Med.2006 Mar;160(3):285-91.
30. Goodman E, Whitacker RC. A prospective study of the role of depression in the development and persistence of adolescent obesity. Pediatrics.2002 Sept; 110(3):497-504.
31. Hasler G, Lissek S, Ajdacic V, Milos G, Gamma A, Eich D, Rossler W, Angst J. Major depression predicts an increase in long-term body weight variability in young adults. Obes Res.2005 Nov; 13(11):1991-8.
32. Chroussos GP. The role of stress and the hypothalamic-pituitary-adrenal axis in the pathogenesis of the metabolic syndrome: neuro-endocrine and target tissue-related causes. Int J Obes Relat Metab Disord.2000 Jun; 24Supp. l 2:S50-5.
33. Bjorntorp P. Do stress reactions cause abdominal obesity and comorbidities. Obes Rev.2001 May; 2(2):73-86.
34. Bjorntorp P. Heart and soul: stress and metabolic syndrome. Scan Cardiovasc J.2001 Jul; 35(3):172-7.
38. American Academy of Pediatrics, Council on Child and Adolescent Health. (1998). The role of home-visitation programs in improving health outcomes for children and families. Pediatrics, 101(3), 486-489.
39. Center for the Study of Social Policy (CSSP). (2007). Strengthening Families: A Guidebook for Early Childhood Programs. (Revised 2nd ed.). Washington, DC: Author.
40. Cohn, A. (1983). An approach to preventing child abuse. (2nd ed.). Chicago, IL: National Committee for Prevention of Child Abuse.