LECTURE.

1 ON INFANTICIDE, BATTERED BABY SYNDROME, SUDDEN INFANT DEATH

SYNDROME

OBJECTIVES
At the end of this lecture the students will be knowing definitions ofInfanticide
Feticide
Still born baby
Dead born body
Maceration
Foetal age estimation
Signs of Live birth
Precipitate Labor/ Unconscious Delivery
Criminal causes of death of new born babies
Autopsy on bodies of new born dead bodies
Child Abuse i.e. Battered Baby Syndrome
Sudden Infant Death Syndrome and its medicolegal aspects.

INFANTICIDE

It means unlawful destruction of a newly born full term viable infant up to one year of age
after birth. It is punishable under SEC 302 PPC. Although most of the new born babies
are destroyed with hours after birth but for Legal purposes newly born infant under this
Act is defined as one who is in the first year of its life.
FOETICIDE is the destruction of the foetus at any time prior to birth.
NEONATICIDE is the destruction of the child in the first month
FILICIDE (Latin filius means son and filia means daughter, is deliberate act of killing of a
child by the parents.
Punishment for infanticide is death, life imprisonment and also fine.

Infanticide differs from ordinary murder. It is necessary for prosecution to prove that
child was alive and viable at the time of birth and criminal violence was applied to foetus
after birth.
According to English Infanticide Act of 1938 the mother may not be held responsible for
killing her child when her mental balance is disturbed by experience of labour and
tension and strain of child birth and its after effects, she is not charged and punishment
is two years imprisonment.
MOTIVE FOR INFANTICIDE:

To get rid of an illegitimate child of a widow or unmarried girl.

Married girls killing female child to escape defame of not having a son (as
Rajputs in India).
Extreme poverty of parents.

Killing of male child by prostitute.

In case of infanticide it is necessary to examine woman for signs of recent delivery and
whether time of delivery corresponds with the age of child to prove that child
belongs to her.
EXAMINATION OF THE CHILD
Examination is carried out to ascertain that.

Was the child born dead if so was it still born or dead born?
Was the child viable, mature or immature?
Was the child born alive? if so has he breathed and extend of breathing.
For how long did the child survived after birth?

What was the cause of death whether natural, accidental or homicidal?

DOES THE CHILD BELONG TO THE ACCUSED WOMAN?
The proof is established by:

Signs of recent delivery or was the delivery compatible with age of child (i.e.
changes in breasts and genital tract.)
Evidence from people with whom the suspected woman has been intimately
related in work or social life
Careful examination by police and doctor of the wrapping in which the child was
thrown e.g. particular newspaper used can lead to the accused.
By sweepers who collect discharges from houses e.g., pads which show stains
of blood or discharges from the vagina and uterus i.e. Lochia because of recent
delivery.

MEDICOLEGAL ASPECTS.
WAS THE CHILD BORN DEAD, IF SO WAS STILLBORN OR DEAD BORN.
It is necessary to distinguish between stillborn and dead born.
STILL BORN OR SILENT CHILD
Child, who has issued from its mother after 28th week or after viability and it did not at
any time after being expelled, breathed or showed any other signs of life.
Still births are frequent being 1:7 births, Proportion in primiparas being 1:11 and are due
o many causes both before and during birth. Still births occur commonly among illiterate
and immature male children, when labour is usually unassisted. If the putrefaction has
started it may occur within the uterus or from outside, when foetus inhales bacteria then
putrefaction starts from within outwards.
DEAD BORN CHILD.
Child who died within the uterus. Age should be above 28th weeks according to some
but some say that age does not count. Dead born child shows signs of.

Rigor mortis before birth making labour and delivery difficult.

Maceration.
Adipocere formation.
Mummification.

Putrefaction.
Continue
When foetus dies in uterus aseptic autolysis of foetus commence, although the body is
sterilized and no bacteria are there, even then also autolysis occurs.
If dead foetus is in uterus surrounded by liquor amnii and remains there for at least 24
hours, then signs of maceration occur. Process is aseptic because the child enclosed in
membranes is in aseptic sterile condition, when membranes rupture, air enters in and
then signs of putrefaction appear
FINDINGS OF MACERATION.

Body is softened, flaccid and when placed on table flattens out.

Emits out unpleasant, disagreeable odour which differs from putrefaction.

Skin is brown or black, not greenish as in putrefaction.

Cuticle is raised in blisters containing red serous fluid, epidermis peels easily
leaving moist and greasy patches.
Bony junctions in the skull and joints are abnormally mobile. Skull bone
sutures are separated and over-ride each other ( this maybe mistaken for crush
injury of skull)

Internal tissues are soft and edematous, turbid red fluid collects in serous
cavities.
Important radiological sign known as Spauldings sign which confirms over
riding, even when foetus is in uterus the +ve sign shows that the foetus is
dead.
Brain is grayish red, pulpy mass.
Umbilical cord is soft, smooth, thickened and is easily lacerated.
Do histological examination if in doubt. Degeneration of nuclear structure and
disintegration of cells of muscular tissue and internal organs.
MACERATION (CONT)

. ROBERTS SIGNAPPEARANCE OF GAS SHADOW IN CHAMBERS OF HEART AND GREAT BLOOD

VESSELS MAY APPEAR BY 12 HOURS, BUT DIFFICULT TO INTERPRET.

HYPERFLEXION OF SPINES IS MORE COMMON.

CROWDING OF THE RIBS SHADOW WITH LOSS OF NORMAL PARALLELISM

If not examined soon after expulsion superimposed on maceration is putrefaction which

masks the signs of maceration.
If not examined soon after death of foetus, air enters genital tract, liquor amni gets
infected and foetus undergoes putrefaction instead of maceration.
FINDING OF PUTREFACTION

Nauseating unpleasant odour.

Green coloration of skin.

Formation of foul smelling gases.

Rarely a child who has remained inside the uterus after death undergo ;
MUMMIFICATION
ADIPOCERE FORMATION
A. FINDINGS OF MUMMIFICATION.

Foetus is dried and shriveled results from.

Deficient blood supply.

Scantly liquor amni.

No air enters uterus.

B. WAS THE CHILD VIABLE?
Foetus of less than seven months of intrauterine life is non viable. If foetus is not mature
and chance of being born alive is deprived by mother, charge against the mother is less
serious then when the foetus is viable.
C. FOETAL AGE DETERMINATION.
HESSS RULE
Foetal age Up to 4 months, square of the months is taken and then length of foetus is
measured i.e.
2 months 2 x 2 = 4 cms
For 3 months 3 x 3 = 9 cms
For 4 months 4 x 4 = 16 cms
After 4th months i.e. from 5th month no of month multiplied by 5 give length of foetus in
cms. Say
at 5 months length is 5 x 5 = 25 cms
at 6 months length is 6 x 5 = 30 cms
at 7 months length is 7 x 5 = 35 cms
at 8 months length is 8 x 5 = 40 cms
at 9 months length is 9 x 5 = 45 cms

D. WEIGHT DETERMINATION
Weight of unborn foetus of 20 weeks is up to 400 Gms. From 20th week onwards for
every one week there is an increase of 100 Gms, up to 36th weeks or for every 4 weeks
rise is 400 Gms. In last months after 36 weeks every week rise of weight is twice i.e.

about 200 Gms. In last week increase is 1 kilogram.

F. WHETHER CHILD WAS BORN ALIVE.
Evidence are:

Circumstantial
By doctor doing post mortem.

CIRCUMSTANTIAL:
Circumstantial evidence is taken in civil cases. Witnesses who saw the child having
muscular movements, twitching of eye lids, hearing heart beats and cries. Pulsation of
cord after child is born is evidence of live birth, mere cry or muscular movement does
not constitute proof of live birth, child may cry in uterus or vagina.
If child cries in uterus ---VAGITUS UTERINALIS.
If child cries in vagina --- VAGITUS VAGINALIS
Muscular movement or flickering of muscles show child is born. Cellular life continues
after death of the child, muscles may twitch for some time after body is dead and it is
therefore not safe to assume that twitching of muscles indicate life.
In criminal cases medical examiner is asked to prove by post mortem that the child was
born alive.
FOLLOWING POINTS ARE NOTED.
SIGNS OF ESTABLISHMENT OF RESPIRATION.
Before birth lungs receive small amount of blood which is necessary. After birth
pulmonary circulation is established. These produce physical changes in form of.
Changes in chest: Flat before birth and arched after birth.
Changes in Diaphragm: Arched up at level of 3rd or 4th rib, if respiration has not taken
place. Descend to the level of 6th 7th Rib after respiration.
CHANGES IN LUNGS
UNBREATHED LUNG BREATHED LUNG.

HYDROSTATIC TEST IS NOT NECESSARY IF.

Foetus is not viable, less than 180 to 210 days.

Foetus is a monster.
Shows signs of intrauterine maceration remaining in uterus till 24 hours after
death.
When stomach has milk or fruit juices which shows that child did survive after
birth.
Changes in Stomach and intestine, Respiration established, air in stomach and
intestine look distended, tie both ends and put in water, if floats in water. This is
Breslaus 2nd life test +ve.

When child was born alive

See diaphragm.
See Lungs and Stomach.

See places of indentations of Ribs on surfaces of Lungs.

STATIC TEST OR FODERS TEST.
Average weight of foetal lungs is 450 500 grams. After respiration is 900 1000 grams.
(Not used in practice)
PLOCQUETS TEST:
Before respiration 1/70 and after respiration 1/35 of body weight
C. HOW LONG THE CHILD SURVIVED:
We see changes in skin.
Changes in circulation.
(If Lungs are not there other things can proof life birth).
Umbilical cord.
Caput succedaneum
Foetal Hemoglobin.
CHANGES IN SKIN:
The skin of a newly born infant is covered with vernex Caseosa chiefly in the flexures of
joints and neck folds. Colour of skin is bright red at birth, becomes darker on 2nd - 3rd
day and physiological jaundice appears between 7 to 10 days. Desquamation o skin
begins about 2nd day and is complete in a forth night.
CAPUT SUCCEDANEUM
Edematous swelling on presenting part of head during delivery which disappears from 24
hours to 7 days after birth
Thanks