The caretaker can do extreme things to fake symptoms of illness in the child. For example, the caretaker may:

Add blood to the child's urine or stool

Withhold food so the child looks like they can't gain weight

Heat up thermometers so it looks like the child has a fever

Make up lab results

Give the child drugs to make the child throw up or have diarrhea

Infect an intravenous (IV) line to make the child sick

What are signs in a caretaker?

Most people with this problem are mothers with small children. Some are adult children taking care of an older parent.

The caretakers often work in health care and know a lot about medical care. They can describe the child's symptoms in great medical detail. They like to be very involved with the health care team and are liked by the staff for the care they give the child.

These caretakers are very involved with their children. They seem devoted to the child. This makes it hard for health professionals to see a diagnosis of Munchausen syndrome by proxy.

What are signs in a child?