This article was written by Carole Jenny, MD, MBA, FAAP. Dr Jenny is professor of pediatrics at Brown Medical School in Providence, RI. She is chair of the American Academy of Pediatrics Committee on Child Abuse and Neglect.

A child protection team consultation is requested by Dr Smith for a 15-month-old with a head injury.

Child was well until she fell, striking her head last week. She was then taken to the hospital, diagnosed with a “viral infection,” and sent home, and subsequently experienced “poor color,” vomiting, and drowsiness. She was normal when the parents left her with maternal grandfather this morning. Dad came home from work at noon; the child, sleepy, was put down in her crib without lunch and grandfather left. At 4:00 pm Dad heard her cry and went to give her a bottle. He states that she was standing up in the crib, holding onto the...

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