Alternative medical practices have become increasingly common among children. This may be especially true within immigrant and muticultural families. In the case of coining or cupping practices, which are thought to draw infections from the body, erythematous and ecchymotic rounded lesions or linear streaks are produced on the body from a suction technique. A careful history taken by the family physician will disclose the correct etiology of the bruising and prevent an unnecessary social service investigation. Fallen fontanella, a practice that involves turning a child upside down to correct a depressed fontanelle, can cause vomiting, diarrhea and dehydration in infants.
Retinal hemorrhages can also occur, and sometimes shaken-baby syndrome is erroneously diagnosed.
Being culturally sensitive and alert to the ways parents and children deal with illness is important among diverse patient populations. The article is a good complement to a previous article in AFP by Bethea. 9 Risk for serious injury and the prevalence of abuse trauma is highest in infants and young children, with the greatest fatalities occurring during the first several months of life. 10 Family physicians must be familiar with development milestones during this period, because the risk of fatalities increases significantly when the diagnosis of child abuse is missed. Statistics reveal that neonaticide accounts for 45 percent of infant deaths within the first 12 months of life, making the newborn nursery evaluation, including parental acceptance of the infant and bonding, a critical component.