Child physical abuse is a serious problem. Here are some facts:

• Most children are abused at home or by someone they know. They often love this person, or are afraid of them, so they do not tell anyone.
• Child abuse can happen to a child of any race, religion, or economic status.

Other types of child abuse are:

• Neglect and emotional abuse
• Sexual abuse
• Shaken baby syndrome

Battered child syndrome; Physical abuse - children

CHILD PHYSICAL ABUSE

Child physical abuse is when a person physically hurts a child. The abuse is not an accident. Here are some examples of child physical abuse:

• Hitting and beating a child
• Hitting a child with an object, such as a belt or a stick
• Kicking a child
• Burning a child with hot water, a cigarette, or an iron
• Holding a child under water
• Tying up a child
• Severely shaking a baby

Signs of physical abuse in a child include:

• Sudden change in behavior or school performance
• Alertness, watching for something bad to happen
• Acting out behavior
• Leaving home early, going home late, and not wanting to go home
• Fear when approached by adults

Other signs include unexplained injuries or a strange explanation of injuries, such as:

• Black eyes
• Broken bones that cannot be explained (for example, infants who do not crawl or walk usually do not get broken bones)
• Bruise marks shaped like hands, fingers, or objects (such as a belt)
• Bruises that cannot be explained by usual child activities
• Bulging fontanelle (soft spot) or separated sutures in an infant's skull
• Burn marks, such as cigarette burns
• Choke marks around the neck
• Circular marks around the wrists or ankles from twisting or being tied up
• Human bite marks
• Lash marks
• Unexplained unconsciousness in an infant

Warning signs that an adult may be abusing a child:

• Cannot explain or gives strange explanations for a child's injuries
• Talks about the child in a negative way
• Uses harsh discipline
• Was abused as a child
• Alcohol or drug problems
• Emotional problems or mental illness
• High stress
• Does not look after the child's hygiene or care
• Does not seem to love or have concern for the child
  

HELP AN ABUSED CHILD

Learn about the signs of child abuse. Recognize when a child might be abused. Get early help for abused children.

If you think a child is being abused, contact a health care provider, the police, or child protective services in your city, county or state.

• Call 911 or the local emergency number for any child in immediate danger because of abuse or neglect.
• You can also call Childhelp National Child Abuse Hotline at 1-800-4-A-CHILD (1-800-422-4453). Crisis counselors are available 24 hours a day, 7 days a week. Interpreters are available to help in 170 languages. The counselor on the phone can help you figure out what steps to take next. All calls are anonymous and confidential.

GETTING HELP FOR THE CHILD AND FAMILY

The child may need treatment and counseling. Abused children can be seriously hurt. Children may also have emotional problems.

Counseling and support groups are available for children and for abusive parents who want to get help.

There are state and other government departments or agencies that are responsible for the protection of children younger than age 18. Child protection agencies usually decide whether the child should go into foster care or can return home. Child protection agencies generally make every effort to reunite families when possible. The system varies from state to state, but usually involves a family court or a court that handles child abuse cases.

American Academy of Pediatrics website. Child abuse and neglect. www.healthychildren.org/English/safety-prevention/at-home/Pages/What-to-Know-about-Child-Abuse.aspx. Updated March 16, 2022. Accessed November 29, 2022.

Dubowitz H, Lane WG. Abused and neglected children. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 16.

Raimer SS, Raimer-Goodman L, Raimer BG. Skin signs of abuse. In: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 90.

US Department of Health and Human Services, Children's Bureau website. Child abuse and neglect. www.acf.hhs.gov/cb/focus-areas/child-abuse-neglect. Updated July 1, 2021. Accessed November 29, 2022.