Munchausen syndrome by proxy is a rare form of child abuse in which a caregiver makes up symptoms and signs so as to make it appear that their child is sick.While in some cases of Munchausen syndrome by proxy the caregiver, usually a parent, simply reports fake symptoms to their doctor, they may also over-exaggerate milder symptoms. Munchausen syndrome by proxy can also involve a parent who actually causes their child to have symptoms, such as by giving them something to make them vomit or have diarrhea, inflicting bruises, or contaminating wounds to make them infected. Doctors will then have difficulty figuring out what is wrong with the child, leading to repeat or long hospitalizations, multiple tests being done, and sometimes surgical procedures. Once Munchausen syndrome by proxy is suspected, the child is often monitored very closely, so that the parent doesn't have any further opportunities to make their child sick and medical staff can directly observe the child for new symptoms. Very typically, any symptoms the parent was reporting quickly go away once the child is being monitored. Child protective services usually gets involved once a diagnosis of Munchausen syndrome by proxy is suspected or made. Since it is often difficult to make a diagnosis of Munchausen syndrome by proxy, it is usually a good idea to involve a pediatrician who has experience with the condition or who is a child abuse expert.