Child protection and the development of child abuse pediatrics in New York City

The history of child abuse pediatrics reflects the development of medicine as a profession influenced by social movements reacting to poverty, economic exploitation, and child maltreatment. As physicians began to specialize in caring for children, egregious cases led them to recognize children were affected by special medical problems and diseases which were compounded by poor conditions and abuse and neglect. They developed the fields of pediatrics and child abuse pediatrics to advocate for their needs in courts and communities. Using a history of prominent physicians and cases, the objectives of this article are to: (1) rediscover the founding of pediatrics in NYC in the context of the environment which served as the setting for its development; (2) highlight our early understanding of the medical issues surrounding child maltreatment, with advocacy and forensic medicine becoming a growing part of medical care for children; and (3) explore the development of child abuse pediatrics in light of prominent physicians making major contributions to child protection. Timelines show the early interplay among social problems, publicized cases, private and governmental agencies, and the development of child abuse pediatrics. The article concludes with potential lessons to be learned and further questions about this interplay of child protection systems and the development of child abuse pediatrics.