Original Article Injuries due to caustics ingestion in children: A psychological approach to the suspicion of childish jealousies Shahrokh Mehrpisheh 1 , Farrokh Taftachi 2 , Leila Abdolkarimi 2 and Azadeh Memarian 2 Abstract Most injuries from caustics ingestion occur due to parental negligence, but other causes such as psychological tendency or childish jealousy or behaviour may be the major cause for harming. Here, we describe a case of injury in a neonate who ingested a caustic substance, probably induced by his brother, but not as a consequence of the negligence of his parents. The mother said she had fed the child toilet bleach instead of water and was very concerned about the child’s condition. However, when the baby’s older brother was interviewed he did not show concern and was very confused and provided contradictory responses about his knowledge of the poisoning. Later, it was revealed that the baby’s brother had prepared the milk and knew what was in it. In our case, damage by caustics ingestion may have been intentional due to psychological problems in parents causing child abuse or in other children due to childish jealousy. Keywords Injuries, Caustics, Ingestion, Jealousies, Children Introduction Injuries due to ingestion of caustics are mostly referred to as tissue injuries from chemical agents, including acidic or alkaline substances. 1 A wide spectrum of fac- tors can determine the severity of injury: the duration of contact with caustics, the volume of fluid ingested, the physical form of the substance involved and its properties such as concentration, pH and potential of permeability in the tissue. 2 When deciding on the volume of neutralizing agents for reducing the injuries, these are the factors to take into account. Epidemiologically, although most forms of caustics ingestion remain asymptomatic or cause mild damages, severe injuries needing therapeutic intervention occur in about 10% of cases. 3,4 About 80% of the injuries caused by caustics inges- tion especially from liquid caustics occur in children under five. These may be very serious and even life- threatening 5 and comprise a large proportion of refer- ences to the coroner. Although most such injuries occur accidentally due to parental negligence, there may be other causes such as psychological problems or childish jealousy or behaviour. 6 We describe a case of injuries by caustics ingestion in a neonate probably because of his brother’s act, but not due to parental negligence. Case presentation A six-day-old male neonate with the history of cyanosis and vomiting due to caustic ingestion was referred to the emergency ward of our hospital. His mother said she had fed the child accidentally with toilet bleach instead of water and was very concerned about the baby’s condition. This concern was not evident in the baby’s older brother, who when interviewed was very confused and provided contradictory answers about what he knew about the nature of this poisoning. In subsequent assessments, it was revealed that the baby’s 1 Neonatology Department Ghazvin University of Medical Science, Ghazvin, Iran 2 Forensic Medicine Department, Rasoul Akram Hospital, Iran University of Medical Science, Tehran, Iran Corresponding author: Azadeh Memarian, Forensic Medicine Department, Rasoul Akram Hospital, Iran University of Medical Science, Tehran, Iran. Email: azade.memarian@gmail.com Medico-Legal Journal 0(0) 1–3 ! The Author(s) 2018 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/0025817218796918 journals.sagepub.com/home/mlj