A rise in babies with head injuries suspected to be caused by abuse has been reported by a specialist children's hospital during the coronavirus pandemic.
Ten babies aged from 17 days to 13 months with suspected abusive head trauma were treated in Great Ormond Street Hospital during the first month of lockdown, according to a journal letter.
During the same period over the previous three years (March 23 - April 23), the London hospital saw an average of 0.67 cases a month.The authors warn that the figures are likely to be an under-estimate given the avoidance of hospitals due to fears of contracting Covid-19.
They warn that the medical community must remain alert to "a more silent pandemic" of domestic child abuse while the coronavirus outbreak continues.
They write in the Archives of Disease in Childhood: "This sobering figure is likely under-represented due to public avoidance of hospitals at this time.
"Notably two parents in our cohort cited fears of contracting SARS-CoV-2 as a reason for delayed presentation."
They add: "Hence, in the background of the intensely public SARS-CoV-2 pandemic, a more silent pandemic is occurring, of which the medical community must remain astutely aware."
The six boys and four girls had symptoms including breathing issues, loss of consciousness, seizures, extensive bruising and swollen scalps when they were taken to hospital.
Head, spine and skeletal scans and body checks revealed blood pooling in the brain in six of the babies, brain swelling, bruising of the brain tissue and skull fractures in four, and a bleed on the brain and bone fractures elsewhere in three.
The babies' families all lived in areas of significant social and economic deprivation, the hospital found.
Two of the parents had a history of criminal activity; three had mental health issues; and four had financial worries - all factors likely to heighten the risk of abusive behaviour, say the authors.
Dr Alison Steele, officer for child protection at the Royal College of Paediatrics and Child Health, said: "This is an extremely concerning report.
"It is important to find out if the huge rise in suspected non-accidental head injury reported at this specialist hospital is being seen by other hospitals across the country."
She added: "Many of these children will have been brought into hospital because there were obvious signs that the child was very unwell, but we are also extremely worried about children who are not being seen because their physical injuries or other forms of abuse or neglect are more easily hidden."
