Paediatricians and child protection officers say they feel increasingly vilified by a public which seems convinced that parents are often falsely accused of harming their children.
By Clare Murphy
Health reporter, BBC News website
Dentists are to be sent guidelines detailing symptoms of abuse
Those active in the field believe a handful of high-profile and tragic cases involving miscarriages of justice have skewed public perception of the very real problem of abuse and left many professionals fearful of reporting their suspicions for fear of the consequences.
At any one time, around 40,000 children are thought to be "at risk" of some form of maltreatment - a broad field, ranging from failure to provide clean clothes and a warm environment to physical abuse. Some 150 children die a year - the majority of whom are infants.
The Royal College of Paediatrics and Child Health is preparing to issue a guidelines on the signs and symptoms of abuse aimed at people who have not previously been targeted by child protection specialists: dentists, for instance, who could spot missing teeth.
"Everybody needs to put their head above the parapet," says Dr Danya Glaser, a consultant child and adolescent psychiatrist at Great Ormond Street Hospital.
"We have become impaled, hooked on a few cases which have been used by the media to cast doubt on the extent of child abuse. We need to start thinking the unthinkable."
According to Dr Paul Davis, a paediatrician at the University of Cardiff, many of his peers do think the unthinkable - but are simply too afraid to report their concerns.
There is little solid evidence documenting the reluctance of specialists to report these fears, but anecdotes abound of paediatricians who refuse to appear as expert witnesses for fear of the flak they may receive after the experiences of two high profile consultants.
Roy Meadow and David Southall were both struck off by the General Medical Council for their misconduct in cases of alleged child murder.
"There is this lack of willingness to diagnose child abuse because of the perceived consequences," said Dr Davis.
"Of course it's always been the case that such suggestions would make parents unhappy, but in recent years it has gone beyond that - it's very hard to stand up to parents and the media coverage.
"There's a lack of balance, and the impression lingers that there are many good parents accused of causing harm to their children."
Dr Davis wants to see a culture where specialists no longer feel so constrained by the burden of certainty before reporting their suspicions.
"Because when you look back at cases where children have been sent home from hospital and then return - injured - and sometimes dead, you will always find there were windows of opportunity."
But encouraging more people to report their suspicions on the basis of less evidence is controversial.
While many accept that public opinion may have been influenced by cases such as those of Angela Canning and Sally Clark - both wrongly convicted of murdering their children on the basis of flawed expert testimony - they note that the consequences of getting it wrong can be truly harrowing.
On the other end of the spectrum, mistrust also lingers in the system after cases such as that of Victoria Climbie, whom social workers failed to protect despite numerous visits.
"The public may have doubts about the system, but there is nothing to suggest that people don't believe abuse is taking place," says Lynne Wrennall, a lecturer in criminology at Liverpool John Moores University.
"What we really don't need though is more people involved in surveillance, which is likely to end up with even more flaky cases going through the courts than we see at present.
"We need to find a way to make sure the serious cases get tackled and children who really are at risk helped, but at the same time to ensure that youngsters are not being placed in care when they really would be better off at home."
Rioch Edwards-Brown was accused by a junior doctor of shaking her baby and had to battle to prove the condition was down to a difficult premature birth. She now heads a group called the Five Percenters, which provides support to people who say they been wrongly accused of shaking their babies.
"We're not here to have a go at doctors - and we have never shied away from the fact that child abuse takes place. But what we need is more thought - specialists need to be given time to review a case properly before making a decision and not rushed into it.
"I understand that doctors feel damned if they do and damned if they don't - but when they say they feel vilified, how do they think it feels to be a parent involved in one of these cases?"