This is an important policy statement because diagnostic imaging studies like x-rays, CAT scans and MRIs can provide documentation of injuries that will later be important in child protection proceedings.

Unfortunately, this type of evidence is not usually available in child abuse cases because doctors do not order the imaging studies. Insurance companies discourage medical practitioners from performing imaging studies to save money.

However, the insurance company’s savings comes at the patient’s cost. Not only is the quality of the medical care diminished, but legal evidence is missed out on.

Imaging studies are often the first sign of abuse in cases were children are initially diagnosed with natural illness.

Some of the new AAP polices are:

* When conducting global skeletal imaging, doctors should use radiographic skeletal surveys instead of other methods when they suspect child abuse

* Doctors must put in place precise protocols for skeletal imaging to assure quality consistency.

* If child abuse is suspected in a child older than 1, doctors may perform skeletal scintigraphies instead of radiographic skeletal surveys if their staff is experienced in pediatric nuclear imaging.

* Doctors MUST perform skeletal imaging surveys when they suspect child abuse of children older than 2

* Doctors MUST perform cranial CT or MRIs when they suspect intracranial injuries to an infant or child.

Do your part in protecting children from abuse. Know the signs of child abuse and report it.

The cooling method has been used successfully since the 1950s in to reduce damage to the brain and other organs caused by heart attacks. More recently it has been used on neurological patients, and about two years ago, doctors began treating newborn infants who have suffered brain injuries.

Babies can suffer brain damage during childbirth for any number of reasons but it almost always stems from a lack of oxygen to the brain. Often, the child does not get enough oxygen because the umbilical cord becomes pinched.

Every year, about 2 to 4 of every 1,000 babies suffer oxygen deprivation at birth. However, doctors will not currently treat their brain injuries with hypothermia therapy unless the infants have reached 36 weeks gestation because premature babies are too fragile for the procedure.

The treatment reduces the infant’s body temperature to 92 degrees. After doctors feel the appropriate amount of time has passed, they gradually warm the infant to a normal body temperature over the course of six hours. As of yet, there are no significant, known side effects to infant cooling.

One hospital has used the therapy on eight oxygen deprived babies to date and only one has died. That infant died not from the cooling itself, but because his birth injuries were so severe. Of course, the full measure of the children’s brain injuries cannot be known until they grow out of the newborn phase.

MRIs can reveal some damage, but not the full extent. Some of the babies who have been treated so far have partial brain injury, and some do not.

The treatment works because cooling reduces swelling, slowing the injury and preventing a cascade of events that causes cell death. The technique saved the life of a newborn that had too little oxygen for almost 15 minutes. That is almost three times longer than it takes for brain damage to occur.

In 2005, an 18-year-old who was cooled amazingly maintained normal brain function after he lost his leg in a boating accident and his heart stopped for 45 minutes.