Medicolegal Problems With Neonaticide

Abstract

Neonaticide, or the killing of an infant within the first month of life, presents many difficulties for pathologists and courts. Births are often concealed and the victims’ bodies hidden. Pathological findings tend to be nonspecific, particularly where deaths have been caused by suffocation, drowning, or failure to provide adequate care and support of newly born infants. Determination of live or stillbirth may not be possible in cases of concealed births as independent witnesses are usually not available to verify mothers’ histories. Whereas changes of maceration indicate intrauterine death, a vital reaction in the umbilical cord stump with milk within the stomach indicates survival for some time after birth. The latter findings will not, however, be present in most deaths that typically occur soon after delivery. Failure to demonstrate inflation of lungs or gas within the stomach does not exclude live birth, and conversely such aeration may occur from resuscitation or postmortem putrefaction. The flotation test is an unreliable indicator of prior respiration. Lack of precise pathological markers for live birth, and/or cause of death, often precludes definitive statements about the manner of death. Stillbirth cannot be excluded in cases where considerable doubts exist.