Violent children’s deaths have become a surrogate indicator of effective child protection but can those who kill children be better identified? A decade-long study of child homicide assailants (population of 2.5 million) is re-examined in the context of nineteen Western nations’ child mortality rates and child-abuse-related deaths, correlated with four international measures of relative poverty, focusing on income inequality. Child mortality rates of the nineteen countries were ranked and correlated with levels of poverty. Child mortality and poverty strongly correlated but, unexpectedly, child-abuse-related deaths did not. Child homicide assailants are extremely rare, but three distinct within-family assailant categories can be identified: mentally ill parents, mothers with a child on the Child Protection Register and men with previous convictions for violence. Mentally ill parents were the most frequent assailants, but violent men killed over five times the rate of mentally ill parents. The juxtaposed results indicate that the assailants’ problems are essentially psycho-criminological, especially violence, rather than socio-economic, although poverty worsens most situations. Despite the dangers of ‘false positives’, children’s services need to give greater weighting to the child protection–psychiatric–violence interface to assist front line staff in improving risk assessment and contribute to reducing the impact that parental mental illness can have on the child.