Branding refers to a traditional practice of producing ‘therapeutic’ burns with hot iron rods over skin in order to treat various conditions. We recently observed multiple partially healed linear scars over all the limbs in a child with Guillain-Barre syndrome, as a result of this unscientific practice. In a study among neonates(1), branding was noted over abdomen in 219/2764 (7.9%) neonates. Unfortunately, 11 of these neonates developed septicemia and 3 expired. In another study(2), 371 neonates with branding were seen over a 10-year period (1982-1991). Eighteen neonates developed septicemia and 3 died.

Branding as a method of treatment is employed for several diseases including jaundice, abdominal pain, convulsions, paralysis (as in our case), failure to thrive, recurrent headaches, etc. Branding is harmful in several ways. Burns occurring as a result of this procedure could get infected and lead to septicemia as discussed above. In addition, it might raise a suspicion of physical abuse in children(3). There are reports of squamous cell carcinoma developing at the sites of branding in cattle and sheep(4), and this needs to be evaluated in children too. Moreover, belief in this method of treatment leads to inevitable delays in seeking qualified medical help. It is well known that people in many parts of India prefer consulting traditional practitioners as initial help. In a recent study from rural India, help from traditional practitioners was sought in more than 70% of children with epilepsy (in 44% as initial help(5). This practice is related to lower costs and more trust in that form of treatment.

Thus, there is an urgent need to abolish this practice. Branding is a criminal offence under Indian Penal Code-324. Extensive education programs explaining its harmful effects aimed at rural illiterate masses including people involved in carrying out branding are required. All physicians need to be aware of this possibility while seeing a child with inexplicable burn scars, lest it might be labeled as physical abuse.

Sudhir Kumar,
Rashmi S.,
Neurology Unit,
Department of Neurological Sciences,
Christian Medical College,
Vellore, Tamilnadu, India 632 004.
E-mail: [email protected]

1. Mohapatra SS. Branding–a prevalent harmful practice in neonatal care. Indian Pediatr 1991; 28: 683-684.

2. Mehta MH, Anand JS, Mehta L, Modha HC, Patel RV. Neonatal branding- towards branding eradication. Indian Pediatr 1992; 29: 788-789.

3. Feldman KW. Pseudoabusive burns in Asian refugees. Am J Dis Child 1984; 138: 768-769.

4. Yeruham I, Perl S, Nyska A. Skin tumours in cattle and sheep after freeze- or heat-branding. J Comp Pathol. 1996; 114: 101-106.