Although the prevalence of this disorder is unknown, consistent publication of case reports in pediatric and psychiatric journals validates that the disorder is increasingly recognized as a serious problem. The MSBP literature to date tends to use a traditional psychodynamic conceptualization of the disorder. One researcher indicates that mothers appear to be very devoted to their children yet cause the children's symptoms. In one case, for example, the mother was caught placing her own menstrual blood into her daughter's urine specimens. This caused numerous diagnostic and invasive procedures to the child before the cause of her symptoms was found. Other researchers have found that children are nonaccidentally poisoned with salt, sugar, and medications. Although mothers may not physically harm their children in a direct way, they indirectly cause what has been termed "medical battering." Researchers have characterized the dynamics of families clinically seen for MSBP as follows: enmeshed mother-child relationships; evidence of multigenerational, exploitative, dominance-submission themes in parent-child relationships; intense family group loyalty; little concern for the child's developmental needs; intergenerational family patterns of illness behavior; and little or no expressed concern over potential harm to the child that results from induced illness and subsequent hospitalization. Explanations for MSBP are offered that focus on gender role theories and transgenerational abuse dynamics, and treatment approaches are suggested. 33 references