You are using an outdated browser. Please upgrade your browser to improve your experience and security.

Infant returned after injuries caused by vitamin D deficiency

Case update – RE: C (Children) [2016] EWFC B45 (4 February 2016)

Care professionals are advised to proceed with caution when children present with metaphyseal fractures, particularly where there may be a risk of vitamin D deficiency.

Amanda Dench, founding partner and head of family law at City of London law firm Miles & Partners, successfully secured the return of an infant to its mother when it was shown that the child’s injuries could be explained by vitamin D deficiency.

This judgment could have significant consequences for how metaphyseal fractures are viewed in such proceedings subsequently. Recorder Coleman stated that ‘while such fractures may ring warning bells, they are not diagnostic of inflicted injury and should not be treated as such.’


When a 13 month old infant, known as T, was taken to hospital with two unexplained fractures the local authority applied for an Interim Care Order.

Amanda Dench was instructed to represent the mother and the father was represented by TV Edwards.

The parents had three children: a girl of 10 years, a boy of 3.5 years, and T, who was aged 13 months at the time. The mother did not want her children to be placed in foster care and research was undertaken to provide the local authority with alternatives including placements with family members and a mother and baby unit.

Initially, the local authority indicated that they would only be seeking removal of T due to the possibility of vitamin D deficiency being an explanation for the fractures. However, they later contended that vitamin D levels were normal, and on that basis they sought the removal of all three children.

How the solicitors at Miles & Partners helped

David Jockelson, an advocate from Miles and Partners successfully represented the mother at the hearing and it was ordered that T would be placed in the care of a paternal aunt under a section 20 agreement. The older two children remained with the parents.

During the initial stages, significant research was put into finding an expert endocrinologist who could address the contested issue of T’s vitamin D. Three medical experts were instructed including a paediatrician, radiologist and an expert endocrinologist. Miles and Partners took the lead in relation to the expert endocrinologist Professor Nussey.

Following receipt of the three experts’ reports and an experts’ meeting, it became clear that there was conflicting medical evidence and complex, medical issues including vitamin D deficiency, mechanism and presentation of metaphyseal fractures. We instructed Alison Grief QC who is known for her expertise is complex medical care cases. The father was also represented by leading counsel.

The judgment

A fact-finding hearing was listed to address the contested medical issues. At the hearing, leading counsel for the mother was able to obtain significant concessions from both the paediatrician and the radiologist in relation to the mechanism and presentation of metaphyseal fractures. These concessions meant that the explanation the mother provided was considered a feasible mechanism for the metaphyseal fracture.

After four days of evidence, the parents were able to collect their son T from the paternal aunt and take him home, following Recorder Coleman indicating that he would not be making any findings against them and that T was injured in the manner the parents described.

Case link

For advice on the law relating to families and children, particularly cases involving care proceedings, contact Amanda Dench at or one of her colleagues in the family team at Miles & Partners on 020 7426 0400.

The contents of this article are for the purposes of general awareness only. They do not purport to constitute legal or professional advice. The law may have changed since this article was published. Readers should not act on the basis of the information included and should take appropriate professional advice upon their own particular circumstances.

Amanda Dench, Miles & Partners Solicitors, London

Amanda Dench


Connect with me: