• By the time she was 8 years old, J.B. had been hospitalized 200 times and had undergone more than 40 operations, including the removal of most of her intestines.

• K.C., a 2-year-old boy, was hospitalized more than 20 times due to complications from asthma, severe pneumonia, mysterious infections, and sudden fevers. His doctors were baffled and unable to determine the cause of these illnesses.

• In a family with five children, one after another died of sudden infant death syndrome (SIDS).

What do these seemingly unrelated cases have in common? All were the result of Munchausen by Proxy Syndrome (MBPS), or Factitious Disorder by Proxy, as it is listed in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). This condition involves the exaggeration or fabrication of illnesses or symptoms by a primary caretaker. J.B.'s medical history was traced to her mother, who manufactured her daughter's illnesses. Similarly, when K.C. was thought to have AIDS, he eventually complained to his mother's friend that his thigh was sore because "Mommy gave me shots." And 23 years after the five babies in one family died, it was determined that SIDS was not the cause, but murder.

What Is MBPS?
In MBPS, an individual - usually a mother - deliberately makes another person (most often an infant or toddler) sick or convinces others that the person is sick. She misleads others into thinking that her child has medical problems by lying and reporting fictitious episodes. She may exaggerate, fabricate, or induce symptoms. As a result, doctors usually order tests, try different types of medications, and may even hospitalize the child or perform surgery to determine the cause.

Typically, the mother knows that these procedures are not needed, but she feels satisfied when she has the attention and sympathy of doctors, nurses, and others who come into contact with her and her child. Because she appears to be so caring and attentive, often no one suspects her. It's not unusual for medical personnel to overlook the possibility of MBPS because it goes against the belief that a mother would never deliberately hurt her child.

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