Over the next few days the Herald will be running a series of articles on child abuse and highlighting charities working to end it. See the bottom of this page for today's charity.
A Papakura baby rushed to hospital with a life-threatening head injury is typical of the many child abuse cases that normally go unreported.
The 4-month-old survived despite initially being in a critical condition in the intensive care unit and is now in the care of his extended family
but experts say he is likely to be affected by his injuries for the rest of his life.
When he was rushed to hospital in August the baby boy had major swelling to his brain from injuries that were believed to be non-accidental.
A 19-year-old year old man is now before the courts charged with wounding with intent to cause grievous bodily harm.
As with many babies who suffer head injuries, it is difficult for doctors to predict what kind of lasting impact the damage will have on the boy.
Starship hospital pediatrician Dr Patrick Kelly, who has given evidence in many child abuse cases, says around one in five babies with serious head injuries dies.
"The research long term hasn't been done in New Zealand to show what happens to the survivors but the international research is that the majority of them will have brain damage - permanent brian injury which is mild, moderate or severe."
Of the 80 per cent who do not die from their injuries, he estimates about a third will have permanent severe damage. Another third will suffer moderate damage.
The remainder will be mild or show no signs of permanent damage - but that does not mean it will not show up later in life.
"The difficulty with the mild or no-brain-injury group is that in babies this age the effects - if they are at the milder end - may not become apparent till the kids are a lot older. They get to school and they start trying to study or concentrate, they might have problems with impulse control or attention."
"The evidence is that the longer you follow these kids you will find that the majority will have some degree of disability long term."
Sometimes that disability may be more psychological or behavioural. One example is an 18-month-old West Auckland toddler taken to hospital last year with a broken thigh bone and broken arm. The injuries were up to a month old and had happened on separate occasions.
His parents are now both before the courts, while he is being cared for by a foster family.
While the breaks have all healed, an officer associated with the case says the boy now displays behavioural problems, including lashing out and hitting people.
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