Non-Mobile Baby Bruise Protocol
Non-mobile babies refer to babies who cannot walk, crawl, roll, or cruise yet. This includes all babies under the age of six months and children who are immobile due to disability or illness. As a result, any bruising or unexplained mark on a non-mobile baby should be taken seriously as it may indicate abusive or neglectful care. There’s a well-known phrase in paediatrics, “those who don’t cruise, rarely bruise.” In simple terms, this means that babies who are not yet moving independently do not usually get bruises by themselves.
What a Bruise Could Indicate
A bruise or mark could indicate:
• Accidental injury (rare in non-mobile babies)
• Medical conditions affecting blood or skin
• Possible non-accidental injury (safeguarding concern)
A bruise occurs when small blood vessels under the skin are damaged, allowing blood to leak into surrounding tissues. In babies, bruises can appear as discoloured marks, often purple, blue, or yellowish as they heal. It is important to note that not all bruises on non-mobile babies are caused by injury. Some babies may have medical conditions that make bruising more likely, such as bleeding or clotting disorders (for example, Haemophilia or Von Willebrand disease) or certain skin conditions.
Immediate Actions for Practitioners
Any practitioner identifying a bruise on a non-mobile baby should inform the Designated Safeguarding Lead (DSL) immediately. Please note that if a baby is seriously ill or injured, call 999 immediately.
Documenting the Situation
It is important to document the situation thoroughly:
• Record the exact size, shape, colour, and location of the mark on a body map
• Note the date and time the bruise was observed
• Record any explanation given by the parent or carer
• Take photographs if allowed by policy, following safeguarding guidance
The Role of the Designated Safeguarding Lead (DSL)
The DSL will decide the next steps according to the NHS and local safeguarding guidance and decide to refer this to a Paediatrician and Children’s Social Care.
The DSL may speak directly with parents to gather information. The conversation is always approached with care, neutrality, and professionalism. The DSL may ask parents where or when the bruise was first noticed, phrasing questions in a neutral and non-judgemental way. The focus is on fact-gathering, not accusation. Parents’ explanations are documented, but even if an explanation is provided, the DSL may still need to follow safeguarding procedures because this is standard practice in the UK for non-mobile babies.
Treating Bruises in Early Years Settings
Bruises on non-mobile babies are always treated as significant in early years settings. Prompt observation, careful documentation, and immediate reporting to the DSL are essential steps to ensure the child’s safety. Communication with parents should be handled sensitively, focusing on fact-gathering and reassurance rather than blame. Following this protocol helps staff act professionally, protects the child, and ensures that safeguarding procedures in line with UK guidance are correctly followed. Ultimately, these steps are about keeping every baby safe and supported.
Useful Links
Safeguarding at Showcase Training: https://showcasetraining.co.uk/safeguarding/
Hampshire Safeguarding Children Partnership: https://www.hampshirescp.org.uk/professionals/toolkits/safeguarding-infants/injuries-in-non-mobile-infants/