
If the child or infant appears ill or injured (including head injuries) seek medical emergency treatment without delay.Please see Appendix: 1 Flow Chart for the Management of Actual or Suspected Bruising in Babies and Children who are not Independently Mobile Bruising on the face is the commonest site for -accidental bruising but only 6% of accidental bruising occurs on the face.Increased bruising with increased family size.Children have more bruises in the summer months.Only one in five infants who is starting to walk by holding on to furniture has bruises.Children who are mobile sustain bruises from everyday activities and accidents.Recurrent injuries or siblings having recurrent injuries.Infant displays wariness or watchfulness.Difficulty in feeding/excessive crying.signs of neglect poor hygiene, presentation or nutrition Other associated features of concern e.g.Associated family factors such as substance misuse, mental health problems and domestic abuse or an unrelated male in the household.Inconsistent of absent explanation from parents/carers.Admission of physical punishment by parents.

Delayed presentation in reporting injury/seeking medical advice.

Other risk factors that should raise concerns are
