INFANTICIDE

- P.Y.A.S.K.GAYATRI
20A101101050.
 INFANTICIDE

DEFINITION: Infanticide is defined as unlawful destruction of child under the age of one
year.

Infanticide literally means killing of an infant. Infant refers to a child from birth, till he can
stand erect. In India, infant means a child upto 12 months after birth (In some countries,
infant is child upto 14 months).

Clinically:
 Term born child - Born at 40 ± 2 Weeks.
 Pre term child - Born before 37 Weeks.
 Post mature child - Born after 42 Weeks.
 Mature child - Weight more than 2.5 kg.
 Pre mature child - Weight 1-2.5 kg., born after 27 weeks.
 Immature child - Weight less than 1 kg, born before 26 weeks.

 FILICIDE : Killing of child older than 24 hours by its own parents.

 FOETICIDE : Killing of fetus at any time prior to birth.
 NEONATICIDE : Killing of infant within 24 hours of birth.

Lawful destruction of a child refers to therapeutic destruction of the child, when it is not
capable of independent existence.

Infanticide in India is considered equivalent to murder and is tried under section 302
I.P.C. In England, mother is not held guilty of infanticide, considering her disturbed mental
condition due to delivery and lactation and she is tried for manslaughter, not murder. In
India, there is no such differentiation.

Law considers every child as born dead and therefore in a case of infanticide, it has to be
proved that the child was born alive and was then killed.
MOTIVES OF INFANTICIDE:

 Illegitimacy of child - An illegitimate child is one who is born not out of a lawful
wedlock. It is done to avoid shame, disgrace from the society.
 Un-married girls / widows become pregnant.
 Married women living apart from husband.
 Poverty of parents.
 Occasionally d/t religious superstitions.
 Female feticide/infanticide.

VIABILITY:

Viability means the physical ability of foetus to lead a separate existence after birth apart
from the mother, by virtue of a certain degree of development.

A child is viable after 210 days intrauterine life and in some cases after 180 days.

Proof of viability:
 General condition of infant
 Weight
 Head circumference
 Crown heel length
 Hasse’s rule
 Ossification centre

Hasse’s rule (Hess rule) – The approximate length of foetus in cm from crown to heel during
1st 5 months is the square of the number of months of pregnancy i.e., the square of the length
in cms. gives the age of foetus in months. After 5 months of gestation, the length in cms is 5
times the month of gestation, i.e., length divided by 5 is the aging months.

FEATURES OF FOETUS AT DIFFERENT AGES

At 1st month - About 1 cm, 2.5 gms, eyes as two dark spots, mouth as cleft and limbs as
small buds.
At 2nd month - 4cms, 10 gms, nose and mouth separate, anus seen as dark spot,
umbilical cord formed.
Centre of ossification in mandible, clavicle, ribs and vertebrae.
rd
At 3 month - 9 cms, 30 gms, neck formed, nails appear, placenta formed.
th
At 4 month - 16 cms, 120 gms, sex can be differentiated, lanugo hair appear on body,
convolutions of brain begin to form, skull bones partly ossified – so foetus
detectable on x-ray, meconium is in dueodenum.
Centre of Ossification in lower segments of sacrum.
th
At 5 month - 25 cms, 400 gms, hair appear on scalp, vernix caseosa present on skin,
meconium at beginning of large intestine.
Centre of Ossicification for calcaneum, pubis and ischium.
At 6th month - 30 cms, 700 gms , skin wrinkled, eye brows and eye lashes appear, testes
close to kidney, meconium in upper part of large intestine.
Centre of Ossification in sternum.
At 7th month - 35 cms, 900-1400 gms, pupillary membrane disappears, nails do not
reach the ends of fingers, testes at external inguinal ring, meconium in
whole of large intestine. Foetus is viable.
Centre of Ossification in talus.
At 8th month - 40 cms, 1.5 to 2 kgs, nails reach tips of fingers, skin not wrinkled, left
testis in scrotum.
Centre of Ossification in sacrum.
At 9th month - 45 cms, 2 to 2.5 kgs, scalp hair about 4 cms, lanugo disappears, scrotum
contains both testes, meconium at end of large intestine.
Centre of Ossification in lower end of femur.
At 10th month - 45 to 50 cms, 2.5 to 3 kgs, scalp hair about 5 cms, face not wrinkled, skin
pale, nails project beyond the fingers but not toes, cartilage in nose and
ears present, testes in scrotum, vulva closed, meconium at rectum, placenta
is 1 cm thick – 22cms diameter and 500 gms in weight.
Centre of Ossification in cuboid and upper end of tibia.

MEDICO LEGAL IMPORTANCE:

In all cases of unexpected infant deaths or cases where the death of an infant is found
under suspicious circumstances the alleged mother and child should be examined.
1. Regarding mother:
Should be examined for signs of recent delivery and her mental condition should
be noted.
2. Regarding the child:
The following medico-legal points should be examined:
A) Whether the child was still born or dead born?
B) Whether the child was born alive?
C) If born alive. How long did the child alive?
D) What was the cause of death?

A) WHETHER THE CHILD WAS STILL BORN OR DEAD BORN?

STILL BORN:
A still born child is one, who is born after 28 weeks of pregnancy, and which do not breathe
or show any other signs of life, any time after being completely born. The child was alive in
utero, but dies during the process of birth.
Characteristics:
 Incidence – About 5% of all pregnancies.
 More common in primi.
 More common for male child.
 More common for illegitimate child.
 Causes:
 Prematurity.
 Congenital defects.
 Birth trauma.
 Placental Abnormalities.
 Toxeamia of pregnancy.
 Erythroblastosis foetalis.
 Intra uterine asphyxia.

Findings:
 Body is absolutely fresh, because not much time has elapsed after death.
 There are features of prolonged labour
- Moulding of head (caput succedenum).
- Edema & bleeding in scalp.

MACERATED STILL BIRTH

DEAD BORN:
It refers to the birth of a dead child, death having occurred in uterus , at any stage of
gestation. Normally delivery occurs about 2 days after death. Depending upon the conditions
in the uterus, the child manifests one of the following three-
I. Signs of maceration – It is a process of aseptic autolysis. Results if there is plenty of
liquor amnii and no air gains entry into the uterus.
Findings:
 General - Body is soft, flattened, reddish purple, emitting Sweet
disagreeable smell.
 Epidermis - There are large blebs containing serous or bloody fluid.
- Epidermis can be easily peeled off (skin slippage).
 Internal Viscera - Abdomen distended.
- Body cavities contain reddish, serous, turbid fluid.
- Internal viscera oedematous.
- Brain is greyish red, pulpy mass.
  Skull - There is overriding of skull bones.
i.e., Spaulding sign is positive.
 Umbilical cord – Is soft, thickened and can be easily damage
 Microscopy examination – Evidence of inhalation of Meconium from liquor
amnii.

SPAULDING SIGN

II. Signs of decomposition / Putrefication – Results if there is sufficient liquor amnii and also
air enters into uterus due to rupture of membranes.
Findings:
a) Body is greyish, foul smelling and bloated.
b) Sometimes body is in rigor-mortis.
III. Signs of mummification – Results when there is less blood supply to fetus, liquor amnii is
scanty and no air enters uterus. It occurs after 2 weeks of IUD.
Findings:
Body is shriveled, thin dark brown and emitting smell like Rotten cheese.

MUMMIFIED BIRTH
 B) WHETHER THE CHILD WAS BORN ALIVE?
As per English law, live born refers to a child, who is completely
Delivered outside the body of the mother, irrespective of severance of the cord and if this
child showed signs of life and is killed, it amounts to infanticide.
As per Indian law, even if a part of the body of the child is outside the body of the mother &
if he was alive – killing him amounts to infanticide.

Evidence of live birth

a. In Civil cases
 Crying.
[At times the child may cry in vagina- Vagitus vaginalis,
Or may cry in uterus, when after rupture of membranes,
Air enters uterus – Vagitus uterinus].
 Muscle movements/sneezing/yawning.
 Pulsating umbilical cord.
 Inspecting, papating or auscultating foetal heart sounds.
 Pain sensation on pinching.
b. In Criminal cases
Court requires establishment of live birth on specific grounds, and considers
establishment of respirationas an important sign of birth.

Signs of Live birth

1. Establishment of respiration
a) Shape of chest.
b) Position of diaphragm.
c) Lungs - Volume
- Consistency
- Colour
- Weight
- Microscopic examination
- Hydrostatic test
2. Changes in Stomach & Intestines
3. Changes in Kidney
1. ESTABLISHMENT OF RESPIRATION- Signs are:

Before respiration After respiration

a)Shape of chest
i. Is flat i. Is arch, dome shape
ii. Circumference of chest is 2-3Cm ii. Circumference of chest is 2-3Cm more
less than circumference of Abdomen that circumference of Abdomen at
at umbilicus. umbilicus.
b) Position of diaphragm
 Is at 4-5 th rib.  Is at 6-7 th rib.
c)Lungs
1. Volume
i. Lungs small. i. Lungs voluminous.
ii. Lying in posterior part of Pleural ii. Fill the whole of the pleural
cavity. cavity.
iii. Margins sharp. iii. Margins rounded.
iv. Pleura thick & loose. iv. Pleura thin & stretched.
2.Consistency
-Lungs are firm and liver like. -Lungs are soft, spongy, elastic.
3.Colour
i. Colour is dark brown, like liver. i. Due to entry of air and passage
of blood, lungs are marbled.
ii. On squeezing the cut section, Little fluid ii. On squeezing the cut section, frothy
blood oozes out. blood oozes out.

4. Weight
i. 30-40gm.(fodere’s test) i. 60-70gm.
ii. Weight of lung is 1/70th of Total body ii. Weight of lungs doubles due to Increased
weight (plocquet’s test). circulation, and 1/35th of total body
weight.
5. Microscopic examination.
i. Alveoli collapsed. i. Alveoli dilated.
ii. Alveoli lined by cuboidal/Columnar ii. Alveoli lined by flat squamous Cells.
cells.
iii. Blood vessels not prominent. iii. Blood vessels patent & Prominent.
iv. Alveolar duct membrane iv. Presence of alveolar duct
Cannot be present. Membranes confirms live birth.
6. Hydrostatic test
Negative Positive
HYDROSTATIC TEST

Definition: Hydrostatic test is the test involving flotation of lungs on water, to confirm live
birth.
Principle: Specific gravity of lungs before respiration 1.04-1.05 which becomes 0.94 after
respiration, so the respired lung floats on water. The increased volume of lungs after
respiration, well compensates the increase in weight after respiration.
Procedure:
I. Both the lungs together along with trachea & larynx are removed and tested for
flotation.
II. If they float, each lung is separately tested.
III. If they float, each lung is cut into 12-20 small pieces & tested for flotation.
IV. If they still float, the pieces are squeezed under pressure & again tested for flotation.

HYDRO STATIC TEST

(A) NEGATIVE (B) POSITIVE

Inference:
 If they float means respiration has taken place.
 If some pieces float and other sink means feeble respiration.
 If they sinking means respiration has not takes place.
Fallacies of hydrostatic test:
 Respired Lung may sink(False negative)
- Acute pulmonary edema
- Bronchopneumonia
- Atelectasis
- Alveolar duct membrane
- Very feeble respiration
 Unrespired lung may float(False positive)
- Presence of decomposition gases
- Artificial reaspiration
- Mouth to mouth insifflation
Hydrostatic test has no relevance:
 Child not viable
 Shows signs of maceration
 Decomposed fetus
 Milk in stomach
 Umbilical cicatrization
 Monster fetus

2. CHANGES IN STOMACH & INTESTINES

a) In case, the child has respired, some of air also enters GIT. Air can be demonstrated
radiologically.
- Air reaches upto stomach – in 5-10 minutes.
- Air reaches upto small intestines – 1-2hrs.
- Air reaches upto colon – 5-6hrs.
- Air reaches upto rectum – 10-12hrs.
b) Breslau’s second life test – In case respiration has occurred, the stomach would also float
on water, because of air present in it(After ligating at both the ends, stomachis removed and
tested for flotation).
This test is useful in case of prevention of air entry into lungs, but it is useless after
decomposition or in cases of attempted artificial respiration.
c) Before respiration, stomach contains only mucous, while after respiration it contains
mucous, air and saliva,so if stomach is punctured under water, air bubbles will be seen.
d) Presence of altered milk in stomach confirms live birth.
e) Presence of blood, meconium & liquor amnii in stomach confirms live birth.(Meconium is
bile+mucous).

3. CHANGES IN KIDNEY
Presence of uric acid crystals, as brown streaks at pelvis of kidney is regarded by some as a
sign of live birth- is not confirmatory.

C) IF BORN ALIVE, HOW LONG DID THE CHILD LIVE?

1. Changes in skin
a) Colour - Bright red - At birth
Brick red – 2nd to 3rd
Yellowish – 3rd to 6th
Normal – 7th to 10th
b) Desquamation of skin - Begins over abdomen by 2 nd day completed by 3rd to 4th day
c) Vernix caseosa - This cheesy secretion(sebaceous secretion+epithelial cells) is
present on skin, especially in folds, at the time of birth. It is
lost after 1-2 days.
2. Caput succedaneum – Because of moulding during, the Presenting part, usually being
head becomes elongated and Swollen, due to the presence of
usually of usually serous fluid. This swelling disappears in 1-3
days.

CAPUT SUCCEDENUM
3. Cephal haematoma – Is gross collection of blood under scalp- usually in forceps
delivery. It resolves in 1-2 weeks.
4. Changes in umbilical cord
2Hrs : Cut margins dries
12-24Hrs : Cord dries
36-48Hrs : Red ring (inflammatory) appears(around umbilicus)
2nd-3rd : Shrivels up
th
5-6 day : Mummifies & falls off leaving a raw area
10-12 days: Raw area heals & cicatrizes
(In putrified bodies these changes will be present)

CHANGES IN UMBILICAL CORD

5. Changes in circulation
Umbilical artery closes ----- 3rd day
Umbilical vein closes ----- 4th day
Ductus arteriousus ----- 10th day
Foramen ovale ----- 2-3 months
6. Changes in middle ear
The gelatinous material in the middle ear, is replaced by air
after few days.(Wrendin’s test).
7. Air in GIT
At stomach - Within 5-10 minutes.
At small intestine - Within 1-2 hrs.
At colon – Within 5-6 hrs.
At rectum – within 10-12 hrs.
D) WHAT WAS THE CAUSE OF DEATH?
It can be classified as:
i. Natural
ii. Unnatural
a. Accidental
1) During delivery
2) After delivery
b. Criminal
1) Acts of commission
2) Acts of omission
i. Natural causes of death in infant/foetus:
 immaturity
 Post maturity
 Malformations
 Congenital diseases
 Anoxia
 Erythroblastosis foetalis
 Bacterial and viral infections
 Diseases of placenta
ii. Unnatural causes of death in infants /foetus:
a. Accidental
1) During delivery
 prolonged labour
 prolapse of cord
 Knots of the cord
 In forceps delivery
 Sudden death of mother

PROLAPSE OF CORD
 2) After delivery
 Drowning
 Suffocation
 Precipitate labour
Definition: It refers to a sudden delivery, without the knowledge of the mother. All
the 3 stages of labour occur simultaneously and suddenly.
Pre-requisites:
Multiparity
History of perineal injury, Small baby.
Causes of death:
Head injury
Drowning in lavatory waters.
Haemorrhage from torn umbilical cord

b. Criminal
1) Acts of commission- It refers to certain acts committed by the mother or anybody
else, so as to cause death of child.
 Suffocation
 Strangulation
 Drowning
 Burning
 Cut throat
 Poisoning
 Blunt head injury
2) Acts of omission- Failure/omitting to take these precautions can be charged with
infanticide, if the child dies.
The precautions expected are-
 Failure to provide assistance during labour
 Failure to legate the cord
 Failure to properly food the child
 Failure to protect child from heat and cold.

ABANDONDING OF A CHILD (SEC.317 IPC):

Father of a child who is under 12 years, or anyone who is having care of such child, leaves
such child in any place with the intention of abandoning the child, shall punished with
imprisonment up to 7 years.

ABONDING OF A CHILD
CONCEALMENT OF BIRTH (SEC.318 IPC):
Whoever, secretly buries or otherwise dispose the dead body of a child, dies before after or
during its birth, intentionally conceals birth of such a child, shall be punished with
imprisonment up to 2 years.

CONCEALMENT OF BIRTH

SUDDEN INFANT DEATH SYNDROME (SIDS):

(Cot / Crib Death)
Definition: SIDS is defined as the sudden natural death of an apparently healthy child, below
2 years usually at 2-4 months and the cause of death cannot be explained even after a careful
P.M. examination, because death usually occurs during sleep, it is also known as cot/crib
death. As per WHO, SIDS, is a natural cause of death.
Characteristics:
Incidence – about 0.3% of all deliveries.
Male : female :: 3:2.
More in twins.
Incidence more in low socio economic group.
Deaths more during late night.

SIDS
Causes:
 Prematurity
 Debility
 Some suggest that these infants have prolonged sleep apnoea – leading to hypoxia and
death.
 Laryngeal spasm.
 Hyper sensitivity of respiratory lumen
P.M: Usually no positive findings
Medico leaga aspect: Cot death may be confused with infanticide and vice versa.