Case for a new paradigm -- Medical child abuse -- How did we get here? -- Uncommon manifestations of Battered child syndrome -- Why has it taken so long? -- So, why do they do it? -- Description of 115 cases referred for possible Munchausen syndrome by proxy -- Introduction to treatment -- Identifying medical child abuse -- Stopping the abuse -- Providing for ongoing safety -- Treating the physical consequences -- Physicians as part of the problem -- Lawyers as part of the solution -- Where do we go from here?