The ICAN Multi-Agency Child Death Review Team was formed in 1978 to review child deaths in which a caretaker was suspected of causing the death. The team is composed of representatives from the Department of Coroner, Los Angeles Police and Sheriff's Departments, District Attorney's Office, Office of County Counsel, Department of Children's Services, Department of Health Services, Department of Mental Health Probation Department, Los Angeles County Fire Department, and Children's Hospital of Los Angeles. A total of 46 child abuse homicides were identified in 1990 in which the perpetrator was in a caretaker role. Although this is a 10-percent increase in child abuse homicides over 1989, the increase is apparently related to better identification of older victims. A gender and age profile of child abuse homicide victims shows that girls are facing increased risk of being homicide victims and that very young children, ages 2 and younger, continue to be victimized at high levels. Data suggest that a minority of victims and families are known to these agencies before the death. The study found that the response of agencies involved in the identification and investigation of child abuse homicides and provision of services to surviving family members is inconsistent. Cases of suspicious deaths with like circumstances are not handled in a predictable or uniform manner. Although the 35-percent decrease in the number of adolescent suicides in 1990 compared to 1989 is encouraging, there is a continued need for study of this population. Among the five recommendations is that ICAN promote expanded efforts to provide outreach services to families with very young children. This might include an exploration of the feasibility of establishing a neonatal home visitation program. 20 tables and 16 figures