Bruises, skin marks, or possible eye injuries in babies

This article explains why we need to ask questions around Bruises, other skin marks, or possible eye injuries if your baby hasn’t started to move or crawl yet.

When your baby is born a midwife or doctor will document bruising, other marks (for example birthmarks), or bleeding within the eye (known as a subconjunctival haemorrhage).

If you notice any marks yourself:

• Please show your midwife or doctor and ask that they are recorded.
• We would also encourage you to take a photo of any marks that are present at your baby’s birth.
• We encourage you to arrange a face to face appointment with your GP if you notice marks or bleeding in the eye after you have been discharged by the midwife

This information is an important record and the hospital has a responsibility to pass this information to us.

When a member of our health visiting team notices a bruise, other skin marks (for example birthmarks), or bleeding within an eye on a baby who is not yet moving or crawling it is our duty to ask you for some more information. We will ask you whether it has been seen by your midwife or doctor and already recorded. If not, we follow Sussex-wide guidance and we may have to refer your baby to be seen by a paediatrician (a doctor specialising in children) – we do this via Children’s Social Care as they arrange these appointments for your baby.

Commonly Asked Questions:

Is bruising common in babies?

Bruising in babies who are not rolling or crawling is unusual. It is very unusual for a baby to get a bruise during everyday activities such as nappy changes, bathing or feeding. Bruising can be related to a health condition which has not been previously identified .

You may feel that you are able to explain the reason for your baby having a bruise or mark. However, your baby will still need to be carefully assessed. A consultant paediatrician (a specialist children’s doctor) will be able to tell the difference between bruises and other types of mark.

What could be the reason for the bruise/unexplained skin mark?

• It might not be a bruise/unexplained skin mark at all – it may be an unusual birthmark not all birthmarks are present at birth but can appear days or weeks later.
• The bruise/unexplained skin mark may be a sign of a medical condition such as a blood disorder which requires further medical investigation.
• The bruise/unexplained skin mark can be a sign that your child has sustained an injury- this may well have been accidental.

All staff in Sussex follow the Bruising in Children who are Not Independently Mobile Guidance which specifies the actions they should take. We aim to ensure that your child receives the best care at all times.

What is going to happen next?

• We will give you a leaflet and explain why we need to refer to Children’s Social Care.
• The professional who discussed your child’s bruise/unexplained skin or eye mark with you has a duty to contact Children’s Social Care. A meeting will be held which includes children’s social care, the Police and a Paediatrician (a doctor specialising in children).
• You will be contacted and given an appointment following the referral. This is most often at your local child development centre or hospital. This is done quickly because if any further treatment or investigations are required it is important this happens as soon as possible for your child.
• At the appointment the paediatrician will ask you about your child, examine your child fully and then decide if any further medical investigations are required. Any information you can give about your child is extremely important in finding out the reason for your child’s bruise/unexplained skin mark.
• The paediatrician will inform Children’s Social Care of the outcome of your child’s examination. You will be told of any decisions taken and if there are any further actions required these will be discussed with you.

A reminder of what to do f you notice any marks yourself:

• Please show your midwife or doctor and ask that they are recorded.
• We would also encourage you to take a photo of any marks that are present at your baby’s birth.
• We encourage you to arrange a face to face appointment with your GP if you notice marks or bleeding in the eye after you have been discharged by the midwife

For more information:

The Guidance we follow.

If you have any questions or concerns please contact us – we welcome suggestions to help us improve our response and support to children and families.