Bruising In Babies:  Is It Normal, Causes And Treatment

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Babies tend to bruise easily as soon as they learn to crawl or take their first steps. Bruises usually appear when babies bump or bang against an object, causing blood from damaged blood vessels to accumulate underneath the skin. Most causes of bruising tend to be benign, but some serious underlying health problems or events could also lead to bruising.

It is good to know the various reasons behind bruising to differentiate serious bruises from harmless ones. Read this post to understand the various causes behind bruises in babies and when to be concerned about it.

Is It Normal For A Baby To Bruise?

It is common for newborns to have bruises on their heads 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 labor or stressful delivery may tend to have darker bruises, 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 inspect any bruises present on the newborn 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 often help avoid bruises due to movement and friction. As the baby gets adept at crawling or walking, you are less likely to see bruises.

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, too. Bruises could be a sign of concern if they appear in places unlikely to develop it, such as around the eyes or ears, soft tissue area in the cheeks, abdomen, buttocks, or inside the mouth (3).

The following conditions or situations could lead to serious bruising, which may be often painful, 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 and what type of medical help is required.
  • Child abuse: Extensive bruising or the appearance of unexplained bruises on babies may indicate child abuse. Bruises on upper arms, neck, ears, and buttocks of specific shapes, such as bite marks, cigarette burns, or belt marks, could be highly indicative of child abuse (4).
  • 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 (5).
  • 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 (6).
  • 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 caused by recent viral infarction in newborn, and could lead to bruises and small purple dots under the skin, known as petechiae (7).
  • Henoch-Schonlein purpura (HSP): HSP is a type of immune disorder that may cause a rash that may resemble a bruise. It may appear on the baby’s arms, legs, or buttocks. It may occur more commonly in older babies and toddlers (8).
  • 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 (9). Minor cases may go undiagnosed until toddlerhood, while severe hemophilia may be diagnosed within infancy.
  • Leukemia: It is a type of blood cancer that could cause bruises as one of the symptoms. 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?

Bruises that appear immediately after birth will be inspected 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 (10).

  • Bruises occur after the baby experienced a severe fall or injury.
  • You notice bruises in immobile infants who do not crawl yet.
  • Bruises are present in unusual places, such as the buttocks, behind the ears, and around the eyes.
  • Multiple bruises and pink spots (petechiae) appear on the baby’s body for no explained reason.
  • Any existing bruise 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.

How To Treat Your Baby’s Bruises?

If your baby develops bruises 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.

How To Prevent Bruises In Babies?

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.

A few causes of serious bruising could be prevented with 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 Question

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 (11). It is less common in cases of iron-deficiency anemia (insufficient iron intake).

Bruising may occur in babies who have a vaginal birth and those who have just begun crawling or walking. Most cases of bruising are seldom a cause for concern. You could avoid bruising by baby-proofing your house and avoiding injuries. If you suspect a serious underlying problem to be the reason for bruising, consult a doctor for a diagnosis.

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