By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Although written several years ago by Dr. Brazelton and Dr. Sparrow for the Families Today column, the content of this article remains relevant today.

(This is the second of a two-part series on child abuse. Last week, Part 1 outlined the problem’s national scope.)

At a conference in Washington last week, reports on child abuse and neglect in the United States revealed a national crisis.

In 2007, an estimated 1,760 children died from abuse and neglect – up 35 percent from 2001, according to federal statistics. In that same year, service agencies received nearly 3.2 million reports of maltreatment.

The deaths are preventable, according to Every Child Matters, a nonprofit advocacy group that issued the report, “Stretched Too Thin: Child Abuse and Neglect in America.”

Much is known about the risks and how to reduce them.

Child abuse and neglect occur in every socioeconomic group, but poverty is a major factor.

A child living in a family with an annual income of $15,000 or less is 22 times more likely to be abused than one in a family with an income of $30,000 or more. One in five American children, more than 14 million, lives in poverty.

Of course, quality education and health care can go a long way toward reducing poverty.

Alcoholism and substance abuse are present in 50 percent or more of child-abuse and neglect cases. Access to drug and alcohol treatment can make all the difference, yet many parents lack that access. Infants and young children are most at risk.

Here are some danger points where parents need extra support:

  1. Colic, or unexplained-end-of-the-day crying, occurs in the majority of infants, and it peaks at eight weeks. Three hours of daily crying that is unresponsive to consolation is hard for any parent, much less one on the edge.
  2. When babies start to crawl and walk, they require a great deal of supervision; overextended parents could blow a fuse during this time.
  3. Toilet training, if feelings of failure and desperation mount on all sides, is another trying time. During these brief intervals of difficult behavior, young children will cry more, cling more, and seek more attention and physical contact from their mothers. If the mother’s relations with her partner are tense, the baby’s crying and clinging may stir up frustration and resentment, which can boil over into abuse. Professionals working with families can help anticipate such challenges and reassure them that no one is to blame. Among the programs that help mothers and fathers become the kind of parents they would like to be: the Parenting Journey, Strengthening Families, and the Nurse Family Partnership.

We have the knowledge to protect children, but we haven’t dedicated adequate resources to putting that knowledge to work.

Family, friends and community also are vitally important in helping at-risk parents to weather the storms of child development. Parents who have someone to talk to are more likely to vent their frustration in that forum rather than taking it out on their children. Caring support can give parents the help they need before they lose control.

(This article was prepared with materials provided by and used with the permission of Every Child Matters,

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Dr. Brazelton heads the Brazelton Touchpoints Project, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is Director of Strategy, Planning and Program Development at the Brazelton Touchpoints Center. Learn more about the Center at

Reprinted with permission from the authors.