National Center Quick-Look

Child Abuse and Neglect, Infants & Children, Ages 4 & Under
Published October 2018

The National Center for Fatality Review and Prevention collects child abuse and neglect information from the NFR-CRS. Since 2004, there have been 3,216 child abuse and neglect deaths of infants and children, ages 4 and under, reviewed by teams.

57% White
33% African American
10% Other / Multi-racial

For every 10 child abuse and neglect deaths, 4 are girls and 6 are boys

Infants account for 52% of child abuse and neglect deaths
52% under one year old
48% 1 – 4 years old

Circumstances Surrounding Deaths:
8 in 10 resulted in child protective services (CPS) action due to the death
7 in 10 occurred in the child’s home
5 in 10 had evidence of prior abuse
4 in 10 had history of child maltreatment prior to death
2 in 10 had an open CPS case with child at time of death
1 in 10 were placed outside of home prior to death

Person Responsible:
Median age – 25 years
6 in 10 – Male
6 in 10 – Biological parent
1 in 10 – Mother’s partner
1 in 10 – Other relatives
1 in 10 – Others

Of deaths reviewed, about 7 in 10 were abuse deaths. Of those, 10 in 10 were due to physical abuse and 6 in 10 were due to abusive head trauma.

Nearly 3 in 10 were neglect deaths. Of those, 7 in 10 were due to failure to protect from hazards and 2 in 10 were due to failure to provide necessities.

Child Maltreatment Fatality Reviews:

An analysis from 2014 of 2,285 maltreatment deaths reported to the NFR-CRS found the number of recommended system changes or planned prevention actions to be disappointingly small.

In September of 2017, the NCFRP convened a meeting of 23 national thought leaders and a child welfare expert from the United Kingdom to develop strategies that can improve review teams’ skills in moving from the case review to action.

This Guidance provides recommendations to help improve child maltreatment reviews with a special focus on being more effective in moving from the case discussion to systems improvement to better protect children and prevent other deaths.

Made possible in part by Cooperative Agreement Numbers UG7MC28482 from the U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB). Its  contents are solely the responsibility of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.

These data represent approximately 70% of the cases entered into NFR-CRS. For more information about the Child Death Review Case Reporting System or about the data contained in this Quick-Look, please visit