Fabricated or induced illness in children highlighted in new guidance

Paediatricians have been provided with new guidance, co-authored by a UCL academic, for cases where there is disagreement between parents or carers and healthcare specialists about a child's health, launched by the Royal College of Paediatrics and Child Health (RCPCH). Perplexing Presentations (PP), Fabricated or Induced Illness (FII) in Children updates the College's 2009 guidance and aims to support paediatricians when involved with these sometimes very difficult cases. It provides procedures for safeguarding children who present with PP or FII and best practice advice in the medical management of these cases to minimise harm to children. The guidance updates definitions of FII and PP. The new and wider interpretation of FII includes any clinical situation where the parent or carer's actions are aimed at convincing doctors and other professionals that a child is more seriously ill than is the case. In these circumstances, the parent or carer may be acting on erroneous beliefs about the child's state of health or, in some cases, deceiving professionals. There is a risk that the child will be directly harmed by the parent or carer's behaviour but in some cases, and inadvertently, also by the medical team's response.