Munchausen's Syndrome by Proxy (MSP)
Munchausen's Syndrome refers to a psychiatric disorder where patients pretend to have illnesses, and therefore are subjected to many medical tests and surgical procedures. Of course, these would never have been performed if the patient had not tried to fabricate them. However, the most notorious patients have often had dozens of surgical procedures for factitious (false) symptoms. Thus, this is a form of self-mutilation.
Munchausen's Syndrome by Proxy (MSP) is a parenting disorder where parents, usually the mother, fabricate symptoms in their children, thus subjecting the child to unnecessary medical tests and/or surgical procedures. In some cases, the parents also inflict injury and can kill their children in the process. MSP is not rare in Apnea Programs. Apnea is the perfect disorder for MSP, because infants appear normal between episodes. Therefore, a parent can bring her baby to a medical facility, fabricate a history of an apparent life threatening event, and the baby will be admitted, many tests performed, sometimes even surgery (such as tracheostomomies) are performed. MSP parents can be quite good at this, often switching from doctor to doctor so that it is difficult for one individual to put it all together. There have been documented cases of MSP in apnea clinics. However, these are much rare than 'true' infant apnea.
There is a profile of a parent who is likely to cause MSP. They are usually the mothers. They are often health professionals, especially nurses and respiratory therapists. They often are very friendly with health professionals and cooperative with medical procedures. They appear quite concerned about their child, and are sometimes described as overly concerned. Some psychiatrists believe that this is an attention-seeking behavior. Obviously, not all health professionals who are nice to deal with have MSP.
I would think that MSP is more likely a problem in Apnea programs than it is in babies who have died from SIDS. The diagnosis of MSP is difficult to make. Pediatricians are uncomfortable even suspecting someone of MSP. After all, in training, pediatricians are trained to listen to parents' histories of their children and to believe them. Confirmation of the diagnosis is very difficult. Covert video-surveillance has been used in some settings, but a court order is often required to do this without the parent's knowledge. When the diagnosis is made, the baby must usually be placed in protective custody and psychotherapy is used on the parents.
