Bruising is the commonest presenting feature of physical abuse in children and therefore bruising in a child of any age is a matter for enquiry and concern. While a high proportion of bruising in older children will be of accidental origin, bruising in children who are not independently mobile (that is not crawling, pulling to stand, walking or confined by disability) is highly predictive of maltreatment.
Infants who are not yet independently mobile (rolling/crawling) should not have bruises without a clear explanation. Numerous serious case reviews, both locally and nationally, have identified the need for heightened concern about any bruising in a baby who is not independently mobile.
The Bruising in Children who are not Independently Mobile Guideline (PDF, 733KB) must be followed in all situations where an actual or suspected bruise is noted in an infant who is not independently mobile.
All practitioners must understand the guideline and be clear on their role and what they need to do, there is also a one minute guide to support this guideline.
Reflective Review Case RR6
Cheshire East Reflective Review RR6 was completed in November 2015. There are lessons to be learnt for practitioners please read the Reflective Review Summary (PDF, 94KB) here. There is also a 7 minute brief on bruising in immobile infants (PDF, 388KB) to accompany this review and support learning.