Bruises in Premobile Infants: A Contested Area of Research, Policy and Practice

Abstract

This paper provides an analysis of the procedures adopted by statutory safeguarding partners throughout England in response to finding bruising in premobile infants. Against the backdrop of empirical research, we begin by challenging the view that bruising in premobile infants can be considered rare and thus suggestive of physical abuse. Then, within the procedure themselves, we point to differences in the definitions of what constitutes a premobile child, differences in the interpretation of research into bruising, and differences in how local authorities require social workers to act. We then discuss the risks involved with over-reaction to bruising in premobile children. Finally, we suggest changes to procedures that would support the appropriate use of discretion by social workers and health staff in this difficult area of practise.

Child Abuse, Misdiagnosed by an Expertise Center: Part I—Medico-Social Aspects

“…The fact that the pre-mobile infant had bruises made this pediatrician suspect a case of child abuse beforehand. However, Bilson described the following reasons for accidental bruises in children who were not yet able to roll over: bumping into the mother’s tooth, falling asleep on a dummy, banging themselves with a fist or rattle, or a toy that was dropped on the baby [ 42 , 43 ]. In this case, the pediatrician ignored a range of similar explanations offered by the parents and grandparents of the child.…”

“…Despite the work by Bilson [ 42 , 43 ], other studies have shown that it can be difficult to find a medical cause for bruising in very young infants, e.g., [ 44 , 45 , 46 , 47 ]. This, however, should not result in a wrong diagnosis of child abuse.…”