Bruises on toddlers

Why do bruises happen?

Bruises appear when tiny blood vessels (capillaries) break or burst. The blood from the capillaries leaks into the soft tissue just under the skin. This is what causes the discoloured patch to appear on your child's skin (NHS 2012).

How should I treat my child's bruise?

To help the healing process, you could try these treatments for your child:

• To reduce swelling, apply an ice pack for 15-minute periods, several times a day, during the first 48 hours (Herbenick 2011, Vorvick 2011). Use a partially thawed packet of frozen peas if you don't have an ice pack. Wrap it in a cloth first, to prevent the cold from hurting your child's skin (Vorvick 2011).
• Arnica gel or cream may help to reduce the pain and swelling (Leu et al 2010, MHRA Nd). It's available without prescription from pharmacies, but always follow the instructions on the packaging.
• If your child seems upset and in pain from his bruise, infant paracetamol or ibuprofen may help (NHS 2011).
• A simple sugary drink like juice or cordial can be a useful analgesic. Don't forget the hugs, kisses and words of comfort.

When should I call the doctor if my child has a bruise?

If your child got his bruise after an accident, such as falling off a bed, or down the stairs, call your doctor, so he can be examined for less obvious injuries. You should also call the doctor if:

• He has banged his head and has a bruise behind his ear. This could be a sign of a skull fracture (NHS 2012).
• The bruise doesn't fade or disappear within two weeks (NHS 2012).
• He is upset and in pain for more than 24 hours (Herbenick 2011).
• The bruise seems swollen and full of pus, and hasn't got better after 48 hours of ice treatment (Vorvick 2011).
• He develops a fever (Vorvick 2011).
• He has lots of unexplained black and blue or purple spots and bruises that aren't associated with injuries. This may mean that he has a bleeding disorder (Vorvick 2011).