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Keeping children safe

Bruising, skin mark or injury in babies and children

Bruising or unexplained marks are rare on a baby who is non-mobile. It is also possible that sometimes a parent might cause an injury accidentally and be able to describe its origin. This could be the case for older children as well as infants.

This page provides information for parents if you or someone else notices a previously unidentified mark on your child/infant, as well as a details of the response process that professionals should follow in these situations.

Unexplained injuries in babies/children – carers information

Please refer to our additional information for parent/carers of what to expect when you or someone else has noticed a previously unidentified mark, injury, or bruise on your child/infant requiring further investigation.

Bruising, skin mark or injury in non-mobile babies – response process

Below is the response process for bruising, skin mark or injury in non-mobile babies. Please also refer to the full Bruising and Injuries to Non-Mobile Children procedures.

In situations where a non-mobile baby has a bruise, skin mark, or injury, consider the following and take the appropriate action.

Professional is aware that skin mark or injury has been recognised and is documented as being due to a medical condition, birth injury/trauma or birth mark.

No further action.

Health Professional has used professional judgement and is satisfied that the skin mark or injury is due to a medical condition, a birth mark, or fits with parent/carer explanation and does not pose risk.

Document this on the patient’s record. Process ends as actioned.

Health professional is unsure of origin of skin mark or if it is a bruise or injury, but feels there are indicators to suggest a birth injury, birth mark or medical condition that has not been recorded/or has only just developed. No indications in history/presentation of abuse.

Is professional identifying injury/bruise or unidentified mark able to arrange same day GP review?

  • If yes – Health professional to book GP appointment. Document outcome, confirm attendance*.
  • If no – Health professional to refer to Paediatrician for same day review. Document outcome, confirm attendance*.

In either situation, does the GP or Paediatrician rule out safeguarding cause due to clinical presentation?

  • If yes – No further action.
  • If no
    • GPs to phone call MASH referral and same day referral to Paediatrician for child protection medical*
    • Paediatricians to phone call MASH referral and child protection medical

* Dependant on your professional assessment of risk will depend if you await confirmation of appointment and then confirm family have arrived at hospital, or if you confirm with parent that they have attended hospital and agree what support they need once outcomed.

Professional suspects origin of a bruise, injury, or skin mark that has not been sufficiently explained suggesting a possible safeguarding concern.

Make a MASH Referral

Phone MASH consultation line on 0345 1551071 and ask to speak to duty social worker (not referral coordinator) to discuss case. Follow their guidance and document this in notes. There may be several different actions from this discussion

MASH advise you to complete a multiagency safeguarding referral.

Usual process:

  • Advise parents of referral process which will support identification of cause through medical examination. Pathway includes a multiagency safeguarding referral being made in case medical cause is not clear.
  • You submit a multiagency safeguarding referral.
  • MASH will contact paediatrician and arrange family’s attendance. MASH will follow up if family do not attend.

Useful numbers and information

Hospital Trust Injury or bruising in non-mobile baby parent information links:


If you are worried about the safety or wellbeing of a child or young person in Devon,
please complete the request for support online form.


If you think that the child is at risk of significant harm,
contact our Front Door directly by calling 0345 155 1071.


In an emergency call 999.