Most child-abuse victims are babies under a year old

Dr Patrick Kelly, clinical director of the child-abuse centre at Auckland's Starship hospital. Photo / Brett Phibbs

Starship doctor says head injuries most common ‘by far’ in 130 admissions of abused children last year.

The majority of children admitted to the Starship hospital as the result of suspected abuse or neglect are under 1 year old.

Figures provided to the Herald under the Official Information Act reveal three children died at the hospital and 130 suspected abuse cases were referred to police between July 1, 2013, and June 30 last year, compared with one death and 122 referrals in 2012/13.

The median age of the children admitted for abuse - or neglect-related injuries was just 5 months.

Starship hospital child protection team leader Dr Patrick Kelly said head injuries were the most common in children admitted with injuries caused by suspected abuse.

"About 20 per cent of these children have other fractures as well, especially rib fractures.

"Outpatients - usually brought in by CYF [Child, Youth and Family] or the police - are usually older children who present with soft-tissue injuries: black eyes, bruising, patterned marks from being slapped or struck with an object."

Dr Kelly said the perpetrator of the abuse was "very variable".

"Like most centres, our anecdotal experience is that male offenders are more common than female offenders, and non-biologically related males - 'stepfathers' - are disproportionately represented," he said.

"However, with very young infants the offender sometimes cannot be reliably identified, and in very young infants the mother can often be the offender, particularly if there are issues like postnatal depression."

Dr Kelly said the cause of most of the abuse-related deaths at the Starship was head injuries "by far".

"Second would be abdominal trauma - children who are kicked or stomped on, but these children tend not to survive to [be admitted to] hospital and come to the pathologists," he said.

Those children were not included in the statistics because the victims were not treated or admitted.

Dr Kelly said it was hard to say why the number presenting at the Starship hospital with injuries consistent with abuse was increasing. "What is clear is that despite all the societal angst and all the expressed interest in intervention and prevention, the incidence is certainly not going down," he said.

Possible contributing factors were family violence, the increase in social inequality in New Zealand and alcohol abuse stemming from a "flood of cheap alcohol".

"We are not good at early intervention," he added.

In 2003 a Unicef Innocenti Research Centre report card, published to monitor the performance of nations in meeting the needs of their children, put New Zealand near the bottom of the OECD countries.

Said Dr Kelly: "As far as I am aware that hasn't changed significantly."