What Causes Bruising In Infants And How To Treat?

✔ Research-backed

Babies have softer skin, and hence they bruise easily, especially when they begin to crawl or walk. Bruises on infants can occur if they hit or bump their bodies against a wall or any object. This may damage blood vessels and lead the blood to clot under the skin. Most bruises in babies are not concerning, but they can be due to underlying morbidity or other problems, as well.

It is good to be aware of the reasons for bruising to differentiate between harmless and harmful ones. Read on to know more about bruises in babies, including their causes and when to worry about them.

In This Article

Is It Normal For A Baby To Bruise?

It is common for newborns to have bruises on their head and body right after vaginal birth (1). The physical stress during childbirth is the reason behind the bruises, which usually vanish within a few days.

Some infants delivered through prolonged or stressful labor may tend to have dark bruises or contusions, usually around the neck, head, and shoulder. In most cases, these bruises do not cause any harm or pain and fade away within a few days. The doctor will examine the newborn for bruises to rule out any serious cause.

Older babies and toddlers could develop bruises when they begin to crawl or take their first steps (2). Parents may observe bruises on the baby’s forehead, elbows, knees, shins, or palms. Dressing the baby appropriately may avoid bruises due to movement and friction. As the baby gets adept at crawling or walking, you are less likely to see bruises.

What Are The Signs Of Bruising In Babies?

The most common signs of bruising in children are discoloration or darkened areas of skin from minor trauma. Bruises typically occur on bony areas like the shins but can appear on the back, stomach, or back of the arm, which warrants medical attention. Other warning signs include worsening bruises after a head injury, sudden unexplained bruising, and bruises that do not begin fading within 3-5 days.

While some bruising is normal, excessive or unusual bruising could indicate an underlying issue like anemia, vitamin deficiency, blood clotting disorder, or rarely even cancer. If bruises do not heal properly or are accompanied by other symptoms like nosebleeds or bleeding gums, testing by a pediatrician may be required. Parents should monitor bruising patterns but allow normal activity, only worrying about persistent, worsening, or unexplained bruises (3).

What Causes Bruises In Babies?

Childbirth and friction while crawling or walking are the common causes for normal bruising among babies. However, there could be other serious underlying causes. Bruises could be a sign of concern if they appear around the eyes or ears, soft tissue area in the cheeks, abdomen, buttocks, or inside the mouth (4).

The following conditions or situations could lead to serious painful bruising in babies.

  • Falls and injuries: When babies start crawling or walking, chances are they might fall and develop a deep bruise on their head, chin, knee, or forehead. Depending on the size of the bruise, parents may determine the extent of the injury or wound and what type of medical help is required.

Besides the reasons mentioned above, babies can develop rashes or bruises for various causes. Michelle, a mother of two, shares her experience of finding a bruise-like rash on her daughter’s tongue, “When I checked on her she yawned and I noticed a mark on her tongue! She had a legitimate bruise on her tongue! She doesn’t even have any teeth yet! ‘The mark’ faded as well, by this morning it was only a slight discoloration. It seems as though she clamped her tongue between her gums and bruised it. This apparently is very common though I don’t recall it ever happening with big brother (her older child) (i).”

  • Child abuse: According to the child maltreatment statistics published by the U.S. Department of Health & Human Services, 28.6% of children under the age of two years are susceptible child abuse victims, of which 15.2% are under the age of one. Extensive bruising or the appearance of unexplained scratches and bruises on babies may indicate child abuse. Bruises on upper arms, neck, ears, and buttocks in specific shapes, like a large bite mark, cigarette burn or belt mark, can be signs of child abuse (5).
protip_icon Quick tip
The rule of TEN-4 says that bruises in the torso, ears, and neck in infants below four months may indicate abuse (18).
  • Vitamin K deficiency: Vitamin K is important for blood clotting. Babies are usually born with low amounts of vitamin K, leading to health problems when not supplemented. Babies may experience bruising or bleeding issues when they experience sustained vitamin K deficiency (6).
Babies may experience bruising due to vitamin K deficiency

Image: Shutterstock

  • Von Willebrand disease: Frequent bruising that occurs easily may also be indicative of Von Willebrand disease, a genetic disorder where the blood does not clot properly (7).
Von Willebrand disease is a genetic disorder where the blood does not clot properly

Image: Shutterstock

  • Idiopathic thrombocytopenic purpura (ITP): It is an autoimmune disorder that causes the breakdown of platelets, leading to low platelet count in the body. It is usually thought to be triggered by a recent viral infection, after which young children develop large bruises and small purple dots under the skin, known as petechiae (8).
  • Henoch-Schonlein purpura (HSP): HSP is a type of immune disorder that can cause abdominal pain,bloody stools, joint pain and a distinctive rash that look like bruises (purpura). It may appear on the baby’s arms, legs, or buttocks, commonly in older babies and toddlers (9).
  • Hemophilia A and B: This genetic condition causes a defective clotting mechanism of the blood. Some of its symptoms are easy bruising and excessive bleeding after cuts (10). Minor cases may go undiagnosed until toddlerhood, while severe hemophilia may be diagnosed within infancy.
  • Leukemia: It is a type of blood cancer that can cause bruises. Children with leukemia will also have low platelet count, low red blood cell count, fever, and unexplained weight loss.
  • Disseminated intravascular coagulation: It is a rare bleeding condition that can cause bruising, bleeding, and uncontrolled blood clotting. Newborns may develop it due to birth injuries or early problems, such as asphyxia, sepsis, and respiratory distress.

When To See A Doctor?

See a doctor if you notice any bruising within the first three months

Image: Shutterstock

Bruises that appear immediately after birth will be examined by the doctor to rule out any serious cause. You must see a doctor if you notice any bruising within the first three months of the baby’s life. You must also see a doctor in the following scenarios (11).

  • Bruises occur after the baby experienced a severe fall or injury.
  • Bruises in immobile infants who do not crawl yet.
  • Bruises present in unusual places, such as the buttocks, behind the ears, and around the eyes.
  • Multiple bruises, signs of inflammation, and pink spots (petechiae) on the baby’s body for no explained reason.
  • Any existing bruise which takes several weeks to heal.
  • Baby displays other signs of a possible underlying problem, such as frequent bleeding, often from the nose, unexplained weight loss, frequent vomiting, loss of appetite, lethargy, or poor weight gain.

It is also good to consult a doctor if you have a family history of genetic problems or if the baby’s sibling has an existing genetic problem. Bruises may often be mistaken for Mongolian spots, which are harmless bluish-black birthmarks. They are not accompanied by other anomalies and occur even in healthy babies.

protip_icon Point to consider
Bruises often resolve within two weeks. During that time, they usually change color, giving an idea of how old the bruise is (19).

How To Treat Your Baby’s Bruises?

Place your baby on softer surfaces for crawling

Image: Shutterstock

If your baby develops bruises or soreness due to crawling or walking, you may dress them in clothes that cover their elbows and knees. You may also place them on softer surfaces, such as a carpet, for crawling. Bruises due to friction do not require any specialized care and get better when the friction is reduced with adequate insulation.

Bruises due to serious causes could require treatment relevant to that condition. The treatment modalities and their intensity and duration will vary based on the underlying cause. For instance, bruises due to injuries could require basic first aid at an outpatient clinic, while bruises due to a genetic condition could require hospitalization. Discuss the potential treatment options and long-term outcomes with your baby’s pediatrician.

protip_icon Quick tip
Apply an ice pack wrapped in a napkin or cloth initially after injury to reduce swelling and discomfort. Then, try warm soaks or a warm bath after a day or two to help the area feel better (20) (21).

How To Prevent Bruises In Babies?

Baby-proof your house to reduce the risk of bruising

Image: Shutterstock

Bruises due to crawling and walking can be prevented by proper insulation. You may also baby-proof your house to reduce the risk of bruising due to sharp objects. A few ways to baby-proof your house is restricting access to furniture and placing a safety gate on the stairway. You must also not leave the baby unattended once they begin to crawl or walk.

Serious bruising can also be prevented with other appropriate measures. For instance, you may prevent the risk of child abuse-related bruising by leaving the baby only in the care of trusted people. Vitamin K deficiency-related bruising can be prevented by providing appropriate supplementation after discussion with a doctor.

If you have a family history of bleeding-related genetic conditions, stay alert to any early signs of it, such as unexplained bleeding and bruising. You may also discuss the appropriate preventive care with a healthcare provider or a specialist in genetic disease.

Frequently Asked Questions

1. Is bruising a sign of anemia?

Bruising may be one of the symptoms of aplastic anemia (insufficient red blood cell production) in some cases (12). It is less common in cases of iron-deficiency anemia (insufficient iron intake).

2. Can low iron cause bruises?

Low levels of iron could lead to symptoms such as bruising, dry skin, and feeling bloated. Tests for iron deficiency can determine the exact causes of bruising and other symptoms since they can be present in various conditions (13).

3. What does a leukemia bruise look like?

Bruises in leukemia may begin as large red patches that may cause pain and tenderness when touched and change color over time. These tiny patches can be clusters and look like a large rash and may often not be visible on the initial days of onset (14).

4. How do I know if a bruise is due to leukemia?

Unexplained bruises without trauma can be signs of leukemia in most cases. However, severe bruising may indicate a lack of platelets or clotting problems. Spontaneous bruises may occur on the legs or arms. This can also appear anywhere in the body (15).

5. How long do bruises last on babies?

The time taken for a bruise to heal may vary per the underlying cause. Bruises due to non-severe reasons may usually heal in a couple of weeks. If the bruise stays too long, spreads, or changes color, consult a doctor (16).

6. Can babies get bruises from teething?

Teething may be associated with bruising in some babies. Bruises may occur with eruption cysts or hematoma. Bruises due to teething do not require specific treatment and resolve without complications (17).

Bruises on infants are common right after vaginal birth or while learning to crawl or walk. These bruises are usually benign and self-heal within a few days or weeks. However, an infant or baby can also get severe bruises due to child abuse, vitamin K deficiency, or underlying health issues. Thus, pediatric consultation is necessary if you notice any bruises on your baby in the first three months after birth. Further, baby-proofing your home is one of the most effective ways to prevent bruises caused by injuries and accidental falls.

Infographic: What Should You Know About Bruises In Babies?

Bruises can occur due to various reasons in babies. If you notice new bruises without known injuries or bruises that are not resolving, it is important to seek medical care. Go through the infographic to learn some facts about bruises in babies.

facts about bruises in babies (infographic)

Illustration: Momjunction Design Team

Key Pointers

  • When a baby’s blood vessels are injured, blood clots form beneath the skin, resulting in bruises. They are usually caused by birth, crawling, or walking.
  • However, some severe causes of bruises in babies are injuries, vitamin K deficiency, Von Willebrand disease, leukemia, etc.
  • If babies frequently bruise themselves while crawling or walking, provide them with proper insulation and make your house baby-proof.

Personal Experience: Source

References

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.

1. Bruising on a newborn child: Birth Injury Help Center
2. Bruising in babies: normal or not?: Riley Children’s Health
3. Is it More Than a Bruise?: Children’s Hospital Colorado
4. Bruises in children: What’s normal and when to worry: Riley Children’s Health
5. Diagnosis and Management of Physical Abuse in Children: American Academy of Pediatrics
6. About Vitamin K Deficiency Bleeding; Centers for Disease Control and Prevention
7. About von Willebrand Disease; Centers for Disease Control and Prevention
8. Idiopathic Thrombocytopenic Purpura: John Hopkins Medicine
9. Henoch-Schönlein Purpura: John Hopkins Vasculitis Center
10. Hemophilia: UCSF Benioff Children’s Hospital
11. Bruises and cuts: American Academy of Pediatrics
12. Aplastic Anemia: Harvard Medical School
13. How To Tell If You Have Iron Deficiency Anemia: Cleveland Clinic
14. Blood Cancer Symptoms And Signs: Blood Cancer UK
15. 16 Silent Signs of Leukemia You Shouldn’t Ignore: Reader’s Digest Canada
16. Bruises in Children: What’s Normal and When to Worry; Riley Children’s Health
17. Teething Concerns: Eruption Cysts: Gateway Dental Group
18. Bruising in Babies: Normal or Not?: : Indiana University Health
19. Bruises: Nemours Children’s Health
20. Bruises and bruising: raisingchildren.net.au
21. What is a Bruise?: Boston Children’s Hospital

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Dr. Dur Afshar Agha is a consultant pediatrician with around 26 years of experience in various medical facilities both in Pakistan and Saudi Arabia. She has headed the Department of Preventive Pediatrics at the prestigious, Children’s Hospital and Institute of Child Health in Pakistan and is a life member of the Pakistan Paediatric Association.

Read full bio of Dr. Dur Afshar Agha