More than 100 children were hospitalized because of neglect by parents and legal guardians in 2005, but that is likely just the tip of the iceberg, according to a Health, Labor and Welfare Ministry study released Monday.

Neglect can take many forms, from inadequate provision of food and clothing to failure to provide proper medical attention when needed, but it has only recently been recognized in Japan as a form of child abuse.

The study is based on questionnaires sent to 570 hospitals handling pediatric cases across the country, drawing responses from 230 facilities. Of the respondents, only 106, or 46 percent, said they had treated neglected children in “the past.”

How far back that goes is uncertain, but during that time, which includes 2005, more than 400 children were hospitalized and a dozen died. Some 21 others suffered from serious aftereffects, they said.

In contrast, child welfare centers across the nation dealt with about 12,000 cases of child neglect in fiscal 2004 alone.

Publicly known cases include a 3-year-old girl in Aichi Prefecture who was kept in a cardboard box and starved to death in 2000, and a third-year junior high school student who nearly starved to death before being taken into protective custody in Kishiwada, Osaka Prefecture, in 2003.

The children hospitalized in 2005 included a 1-year-old boy in Kyushu who weighed the same as a 4- to 5-month-old infant. His parents said they had been feeding him with convenience store rice balls — a food he was too young to digest — prompting the doctor to report them to a child welfare center.

Of the 106 victims hospitalized in 2005, 55 recovered fully, but eight others were stricken by serious aftereffects. No fatalities were reported by the responding hospitals.

Many were suffering from insufficient weight gain, while others suffered mental disorders, convulsions, low body temperature and other serious conditions that required emergency treatment.

Of the 106 cases, 97 were reported to public child welfare centers as abuse, according to the study.

Before 2005, 310 children were reportedly hospitalized for neglect, with 12 dying and 13 developing serious aftereffects.

A 10-month-old girl was found dead at home by her parents about four years ago, and a postmortem showed she died of starvation, a doctor at a hospital in Kyushu said.

Cases tend to be more serious the younger a child is, but parents often rush them to the hospital only when they’ve taken a turn for the worse, the doctor said, calling for early recognition and treatment.

Another doctor who participated in the survey, Shinya Miyamoto, a professor on mental dysfunctions at the University of Tsukuba, also called for early detection and prevention of child neglect.

Health authorities should seize every opportunity to that end, Miyamoto said.

A doctor at a university hospital in the Kansai region who saved the life of an elementary school child who suffered from development impairment several years ago said parents and their children should be taken care of because parents sometimes suffer from insecurity and isolation.

Tsuneo Yoshida, a professor of child welfare legislation at Suruga University, said efforts to deal with the problem should involve not only medical institutions but also schools and communities.

Although it is more difficult to detect early cases of child neglect compared with cases of physical abuse, rising public awareness of the issue has caused medical experts to pay more attention to child neglect, he said.

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