Pre-mobile babies with a bruise must always be assessed by a senior doctor/clinician at the earliest opportunity.

• It is not possible to age a bruise based on a naked eye assessment.¹
• Bruising was the most common injury in children who have been abused.
• Accidental bruising is rare in pre-mobile infants.

Bruising features which are suggestive of physical abuse:

• Bruising in children who are not independently mobile.
• Bruises which appear away from bony prominences.
• Bruises to the face, abdomen, arms, buttocks, ears, neck and hands.
• Multiple bruises in clusters.
• Multiple bruises of uniform shape.
• Bruises which carry the imprint of an implement or a ligature.
• Bruises accompanies by petechiae, in the absence of underlying bleeding disorders.

1. RCPCH (2020): Child protection evidence systematic review on bruising.

• 1-4 weeks: loves looking at faces, can fix and follow
• 6 weeks: develops a social smile
• 4-12 weeks: lifts head while lying prone, starts to roll
• 3-5 months: reaches for objects
• 5 months: mouths all objects
• 6 months: passes objects from one hand to the other
• 6-8 months: starts to sit without support
• 6-9 months: starts trying to crawl
• 9-11 months: learns to drop items
• 10-18 months: learns to walk, very unsteadily at first