I attended the Crimes Against Children Conference last week and something along the lines of this topic was covered. This is now termed "Medical Child Abuse" pretty clearly and thats what you need to report to open a new CPS case against the family before this kid turns 18! This is clear "Medical Neglect" as well. I would suggest involving your closest Child Abuse Pediatrician to help navigate this and they are a great liaison with CPS and reviewing the case. 

Per the lectures I sat in on at the conference last week, they even say significant obesity and significant dental caries in patients is CPS reportable (similar to Failure to Thrive) - we see these all the time and may be missing opportunities to help these children. Remember we aren't playing the bad guys here - the goal is not to take away custody, the hope is to provide resources and get the family provide the children the treatment they need. 

Good luck! 

Lexi Guiner-da Silva MD
UT Southwestern Medical Center 
Children's Medical Center Dallas

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