Can infants and very young children be affected by sexual abuse?

Understanding Sexual Abuse in Early Childhood

Yes, infants and very young children can be affected by sexual abuse, even if they are unable to verbally express what has happened to them. Sexual abuse encompasses a wide range of acts between a child and an adult or an older child, and these acts may or may not involve physical contact. For example, abuse may include exposing the child's genitals, pressuring them to engage in sexual activity, or using the child for pornography. In most cases, the perpetrator is someone the child knows, such as family friends, neighbors, or babysitters, and approximately one-third of perpetrators are relatives of the child. The majority of perpetrators are male [1].

Warning Signs in Infants and Young Children

Although infants and young children may not be able to express themselves with words, there are behavioral and physical signs that may indicate they have been subjected to sexual abuse. It is important to note that these signs may be caused by other reasons, but they require urgent medical evaluation. These signs include:

• Bowel control problems, such as encopresis (soiling) or enuresis (bedwetting) [2].
• Eating problems, such as anorexia [2].
• Genital or rectal problems, such as pain during urination, vaginal itching, or discharge [2].
• Difficulty sitting or standing [2].
• Headaches or stomach aches [2].
• Sleep problems [2].
• Behavioral changes such as withdrawal, secrecy, extreme fear, or lack of interest in usual activities [2].
• Development of sexually transmitted diseases or pregnancy (in very rare cases for older children within this age group) [2].

What to Do If You Suspect Abuse

If you suspect that a child has been sexually abused, it is essential to act quickly. The child should be examined by a healthcare provider experienced in sexual abuse cases. Most pediatricians, family physicians, and emergency room providers can perform this examination. The examination should be done immediately or within 2 to 3 days of discovering the abuse, as signs of sexual abuse may not persist for long [2].

During the examination, the doctor will look for signs of physical and sexual abuse, and check the mouth, throat, anus, and penis or vagina. Blood or other tests may be conducted to check for sexually transmitted diseases and pregnancy, and photos of any injuries may be taken if necessary [2].

Support and Care After Abuse

In addition to immediate medical care, children who have been sexually abused need mental health counseling. Recovery from sexual abuse is possible but requires specialized and comprehensive support for the child and their family. The child must be protected from the perpetrator, which may require placement with a non-abusing parent, another relative, or in foster care [2]. For more information on how to protect children and support victims, you can visit Child Sexual Abuse: Understanding, Protection, and Supporting Victims (Arabic).

Medical references

• Child Sexual Abuse
• Sexual abuse in children - what to know