FII is a broad term to describe a group of behaviours by parents or caregivers which cause harm to children [1].

These behaviours include [2,3]:

  • Fabrication (invention) of symptoms or signs
  • Fabrication of supporting evidence, e.g. seizure diaries
  • Direct induction of illness, e.g. smothering, poisoning

Illnesses may include practically any condition [1]:

  • Medical
  • Surgical
  • Psychiatric
  • Physical disability
  • Learning difficulties and special educational needs


This term has replaced ‘Munchausen syndrome by proxy [4,5]. This term was thought to be unhelpful because:

  • It suggested a single parental diagnosis to explain behaviours [1]
  • It takes the focus away from the potential harm to the child [1]
  • It does not account for grey areas where it is unclear if the carer genuinely believes the child to be unwell or is anxious, misinformed or deluded [2]

FII should be used as it is a descriptive term which keeps the focus on establishing what has happened to the child.

“The determination of what, if any, harm has been caused to the child is more important than semantic debates” [2]

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