This case study will follow the child abuse history of a five year old boy. In 2016 he was examined by a forensic nurse for physical abuse injuries, in 2017 he returns to school after his summer vacation looking gaunt with significant weight loss. What would you do as a teacher, social worker, child protective services worker or medical professional in seeing this child? Most would feed the child, most would do this due to concern and caring, not realising how serious this would become for the small boy. He was again referred to the forensic nurse team for documentation of his injuries, where his condition was questioned further than the initial providers. Now six year old boy was subsequently diagnosed with refeeding syndrome. First recorded during the second world war, when prisoners were released from concentration camps, after being starved, many ate too much often, quickly, and then died. The presentation will discuss the sign and symptoms of this syndrome, including the metabolic abnormalities that occur when a malnourished person begins to feed again. It will include the treatment and recovery program for the child. The outcome of the case from a criminal disposition and education of the multi-disciplinary team, so that caring would not put another child at risk.