Child abuse: the increased risk for siblings

We report the cases of four abused children from two families, in which des pite a correct medical diagnosis social and legal measures failed to protec t children from further harms and injuries. As a consequence one of the chi ldren already seriously harmed by abuse was injured again; in both families a second sibling suffered severe physical injuries with fatal outcome in o ne child. Once a case of child abuse is diagnosed, further injury of the primarily af fected child must be avoided under all circumstances. Another important con sideration is the serious risk of abuse for siblings, both for those alread y living in the family and for those yet unborn. Even if parents have alrea dy lost custody for the primarily abused child, preventive measures must be taken for the protection of those children remaining with their parents.