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Munchausen Syndrome by Proxy

Alan Kwasman, MD
Arch Pediatr Adolesc Med. 1997;151(2):211-212. doi:10.1001/archpedi.1997.02170390101026.
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I enjoyed the article by Donald and Jureidini1 about Munchausen syndrome by proxy, but the authors' emphasis on the role of the medical system in this condition ignores one thing: the role of the social welfare system in this condition.

I would like to call "Donald syndrome" Munchausen syndrome by proxy type 1, and I would like to propose a Munchausen by proxy type 2. In this case, the mother would feign an illness in a child for the secondary gain associated with the social welfare system, as shown in the following abbreviated report of a case.

A 2-month-old was seen in my service for the first time with a history of recurrent feeding problems and poor weight gain. The mother suggested that because "this was her third admission for feeding problems then perhaps [we] could put a feeding tube in the baby for a couple months, just until


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