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.