Child murder by mothers : patterns and prevention SPECIAL ARTICLE

When a young child is murdered, the most frequent perpetrator is a victim’s parent or stepparent (1). Rates of infanticide parallel suicide rates rather than murder rates (2). The risk of being a homicide victim is highest during the first year of life (3-5). Though the US has the highest rates of child homicide (8.0/100,000 for infants, 2.5/100,000 for preschool-age children, and 1.5/100,000 for school-age children), the problem of child homicide transcends national boundaries (6). These rates of child murder are probably underestimates, due to inaccurate coroner rulings and some bodies never being discovered (4,7,8). Maternal filicide is defined as child murder by the mother. Infanticide is child murder in the first year of life. The term neonaticide was coined by Resnick (9) to describe murder of an infant within the first 24 hours of life. Almost all neonaticides are committed by mothers. Neonaticidal mothers are often young, unmarried women with unwanted pregnancies who receive no prenatal care. For a detailed analysis of the neonaticide literature and a discussion of neonaticide prevention, the reader is referred to our recent review (10). Resnick’s review of the world psychiatric literature on maternal filicide (11) found filicidal mothers to have frequent depression, psychosis, prior mental health treatment, and suicidal thoughts. Maternal filicide perpetrators have five major motives: a) in an altruistic filicide, a mother kills her child out of love; she believes death to be in the child’s best interest (for example, a suicidal mother may not wish to leave her motherless child to face an intolerable world; or a psychotic mother may believe that she is saving her child from a fate worse than death); b) in an acutely psychotic filicide, a psychotic or delirious mother kills her child without any comprehensible motive (for example, a mother may follow command hallucinations to kill); c) when fatal maltreatment filicide occurs, death is usually not the anticipated outcome; it results from cumulative child abuse, neglect, or Munchausen syndrome by proxy; d) in an unwanted child filicide, a mother thinks of her child as a hindrance; e) the most rare, spouse revenge filicide occurs when a mother kills her child specifically to emotionally harm that child’s father. In developing countries, the preference for male infants may lead to sex-selective killings (12,13). Cultural and legal differences across countries may affect research findings. For example, one country’s correctional sample may be similar to another country’s psychiatric sample, depending on the laws and attitudes toward prosecution. The purposes of this paper are to summarize recent research findings about maternal filicide, and to consider potential strategies for prevention. The authors completed database searches for peer-reviewed articles in English regarding maternal filicide over the past quarter century. Studies were separated by population type, as in our previous analysis (14), because studies in the general population differ from those in psychiatric or correctional populations. Maternal filicide-suicide (a mother kills both her child and herself) was considered independently.