Some mothers deliberately make their children sick for money. Photo / Getty
"Million dollar baby" was the seemingly innocent pet name Hannah Milbrandt's mother, Teresa, gave her as a child.
But this nickname now reveals a more sinister side to Teresa, who robbed her community of more than $43,500 by pretending her 7-year-old had cancer.
Teresa's elaborate hoax deceived more than 65 people in her close-knit Ohio town, which held regular bake sales and fundraisers for her "sick" child.
It was more than 14 years ago, but Hannah, now 21, still remembers it clearly.
While other primary school children were out playing, Hannah says she was sent to death counselling - psychiatric sessions designed to help the terminally ill prepare for the end of life.
She recalls her mother shaving her head to make it look like she had leukaemia, feeding her sleeping pills and forcing her to wear bandages and a surgical mask over her mouth.
"If I ever spoke to her again, I'd ask her why. I'd say it was the financial situation because she was always worried about money, always wanting to have more money than what we had. That's probably the culprit of what a lot of it was," Hannah says.
After a teacher noticed that Hannah's hair was growing back and that she was not acting as ill as her mother claimed, an investigation began.
The nine months of deceit finally ended in 2003 when Teresa was put behind bars for six and a half years for theft and child endangerment.
Hannah's father, Robert, also received four years and 11 months in prison, despite Hannah believing wholeheartedly in his innocence.
It is likely that Hannah's mother's case was one of Malingering by Proxy. Unlike Munchausen by Proxy, when a caregiver feigns, exaggerates or induces illness in another to meet psychological needs, Malingering by Proxy is when the abuse is sparked by financial or tangible motives.
Dr Marc Feldman, a psychiatrist and expert in the field says that in both disorders the caregiver is usually the mother, and the victim, her own child.
Feldman insists that the small number of documented cases is a reflection of the syndrome being "under recognised", as most cases are never brought to light.
For Malingering by Proxy survivors, the lasting impact of abuse shows up in self-harm scars, health problems and mental trauma, but the abuse may start with something as simple as their mother pinching their arm.
Hannah continues to suffer mental health issues and recalls multiple suicide attempts as a teen before seeking professional help for depression.
Sadly, stories like Hannah's are not uncommon among survivors of Malingering by Proxy and Munchausen by Proxy. Feldman says he has encountered instances of mothers suffocating their own children until they lose consciousness and caregivers infecting children's urine and stool samples with blood.
Some survivors recall being fed up to eight different drugs by their parents for illnesses of which they were never formally diagnosed.
Melanie* is another survivor.
"My mother said I was schizophrenic, I had multiple personality disorder, anxiety disorder, she even tried to put epilepsy on me. When I was properly tested the doctors found nothing," she says.
Melanie says her mother was having an affair with her daughter's nurse, which allowed her unwarranted access to drugs that she force-fed Melanie without a proper prescription.
This nurse was later stripped of her medical registration when the hospital discovered the truth. Melanie recalls that "at one point I was on so many medications that I honestly should have overdosed. I remember my feet swelling up so much that I could only wear croc shoes."
But one of the worst episodes occurred when Melanie was 13 years old. Her mother told her that they were going on holiday but when Melanie woke up later that night, she wasn't in her mum's car, but inside an ambulance being transported to a psych ward.
"My mum kept saying how proud she was of me. That I had realised that she didn't have enough love to bear for me. That she had to focus on her other more sickly children," Melanie says.
After nine days of hospitalisation where Melanie was slowly weaned off the medication her mother had given her, her aunt showed up and announced she had been awarded legal guardian of Melanie.
Later her aunt confessed she had been concerned about the sheer amount of medication Melanie was taking and the fact that she "couldn't even hold a cell phone without shaking".
Feldman says the motive of Malingering by Proxy perpetrators is money. He says sometimes they, "seek drugs or disability payments or other tangible means".
Besides taking out life insurance in Melanie's name, listing herself the sole beneficiary, Melanie's mother reportedly stole $12,000 from her savings account and raked up $65,000 in credit card debt. Melanie says that they still don't know what happened to the money but because of her mother's criminal activity there's a "two and a half foot file in Salem County right now".
Hannah also believes her mother was motivated by money, claiming, "she knew that I was worth millions. She could get as much money as she could out of me because I was loved in my community."
Some academics remain sceptical of the Munchausen by Proxy and Malingering by Proxy syndromes, believing the diagnosis is based on opinion and suspicion rather than on pure medical evidence.
One such expert is Dr Helen Hayward-Brown, a medical anthropologist with a doctorate in false accusations of Munchausen by Proxy.
Hayward-Brown has assisted more than 100 women falsely accused of the syndrome in the past 25 years. She says that the diagnosis is too readily placed on mothers when doctors "would rather accept that a mother is harming a child than accept that they don't know what's wrong with the child, that they might've made a mistake, that their knowledge is not finite".
She estimates that 80 per cent of the cases that end up on her desk are medical error where doctors have mixed up children's files, blood tests or have not completed the proper medical procedures.
Hayward-Brown believes that using terms such as "Malingering" creates moral panic where women are condemned by their communities, become unable to find employment or receive medical treatment and often have their children taken away from them.
In fact, New South Wales has one of the highest levels of child removals of any state, not just in Australia, but in the world. Hayward-Brown claims that she's had to stop five women from committing suicide in the past six months because of the mothers' fears of losing their children.
The prevalence of false accusations, however, does not take away from the very real trauma that remains for survivors like Melanie and Hannah. The two women say that although they will never forget the horrendous abuse they suffered when they were children, they are determined to break the cycle. Melanie is now a stepmum and although Hannah struggles daily with "not having a mum", she believes that her life has come full circle.
Now studying English and Education at her local university, Hannah believes she's "taken a lot more positive than I have negative" out of the situation.
"Everything I've been through has made me who I am, and I am very proud of the person that I have become. It's been a giant life lesson that I wouldn't take any of that back," Hannah says.
* Name has been changed.
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