In 1992, seven state WIC agencies used battering during pregnancy as a nutrition risk criterion (see Table 7-1).
The nutrition risk of battering is documented for women. There is a theoretical basis but no documentation of benefit via improved outcome of pregnancy as a result of WIC participation. The committee recommends use of battering as a nutrition risk criterion for women by the WIC program, unless contradictory information becomes available, and that it remain in the predisposing risks category.
Child neglect is defined as an omission of care by a child's primary caregiver that produces harm, such as inadequate nutrition, clothing, or medical attention (Children's Bureau, DHEW, 1978; Gaudin, 1993). Child maltreatment includes physical abuse, sexual abuse, neglect and emotional maltreatment (NRC, 1993).
Reports of child abuse or neglect have increased dramatically, perhaps because of increased reporting, but the actual prevalence of this condition is not known (Johnson, 1995; Wilcox and Marks, 1995). Surveillance of child abuse is limited by a lack of consistent definitions, differences in legal requirements, and the lack of standardization of recordkeeping (Wilcox and Marks, 1995). It has been estimated that each year approximately 2 million children in the United States are seriously abused by their caregivers, and this leads to death in about 1,000 of these cases (AMA, 1992).
Child abuse or neglect can occur in any family. Abuse or neglect is more likely to occur when parents or other caregivers who live under difficult social conditions have little knowledge of child development and unrealistic expectations of child behavior (Johnson, 1995). Child abuse or neglect is reported more frequently among poor families, perhaps in part because of increased attention to the health and social issues among the poor. Psychosocial stress, unplanned pregnancy, teenage parents, low levels of education, and substance abuse are all associated with child abuse and neglect. Child abuse and spousal abuse are related, and parents who were themselves abused as children