Pediatric Starvation by Neglect

Abstract

Starvation due to neglect is a form of fatal child abuse. Although a thorough autopsy examination for organic causes of malnutrition is warranted, the detection or exclusion of such a disease is not determinative for the manner of death. When neglect results in these deaths, it is irrelevant for the manner determination whether the malnutrition is caused by untreated disease or by inadequate feeding. The physical appearance of the child should be documented photographically at autopsy. Autopsy measurements, vitreous analysis, radiology, scene and medical history investigations, and histologic examinations are important components of the death investigation. Secondary infections are common immediate causes of death with malnutrition, however, they should not be listed as the underlying cause of death. The proximate cause of death is malnutrition/starvation. If neglect is involved with the malnutrition, these deaths are appropriately certified as homicides.