Bruises in Children: Normal or Child Abuse?

Tomika S. Harris, DNP, MSN, CPNP


J Pediatr Health Care. 2010;24(4):216-221. 

In This Article

Developmental Considerations

The age of a child with bruising is an important consideration (Chadwick, 1992). Bruises in very young infants in any location are uncommon. In infants less than 9 months without a known medical condition, bruises are suspicious for abuse (Sugar, Taylor, & Feldman, 1999). The developmental level of young children also must be considered when distinguishing accidental versus non-accidental bruises. As children begin to cruise and walk, bruises are seen more frequently. After 9 months of age, bruises commonly are seen on the bony prominences of the limbs (Carpenter, 1999; Labbe & Caouette, 2001; Sugar et al, 1999). Between 9 months and 4 years of age, the forehead is also a common site of injury in normal children. Sites rarely affected in normal children of any age but common in abused children include the face, head, neck, trunk, and buttocks (Labbe & Caouette; Maguire, Mann, Sibert, & Kemp, 2005).


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