Child Maltreatment Red Flags: Two Cases of Bruising in Premobile Infants

Abstract

Child maltreatment is a serious public health concern in the United States. Young infants and children younger than 3 years are at the highest risk of being abused and can experience both acute injuries and long-term developmental, behavioral, and mental health problems. Health care providers are mandated reporters of suspected abuse but may misdiagnose potentially abusive injuries because of lack of knowledge in recognizing maltreatment. Premobile infants rarely have bruising or intraoral injuries without a reported accident or underlying systemic disease and should raise concern for abuse. It is not uncommon for an abused child to present with an injury that at first glance may seem trivial but is actually suspicious for physical abuse and later be found to have abusive fractures or head trauma. The following case presentations show the importance of recognizing sentinel injuries and red flags for maltreatment in young, premobile infants with unexplained bruises.