Bruise in the child

A bruise in a child, also known as a hematoma, is the result of a blunt external force on the tissue. Young children often get this injury while playing with others or doing sports. Due to the sudden increase in pressure on the affected area, the small blood vessels in the tissue burst, blood escapes and is deposited under the skin. In most cases, the skin surface is not injured and remains intact. They are often uncomfortable and painful. As a rule, bruises are not very harmful and heal quickly. Bruising in the baby can also occur.


There are many different causes of bruising in children. Bruising occurs as a result of blunt violence. These can occur in children especially when they fall, play or do sports.

In addition, bruises can also occur as a result of surgery or dental treatment. The blood escaping during these interventions flows from the injured body tissue into a pre-formed body cavity or the surrounding tissue.

Small children who suffer traumatic brain injury in an accident can also develop a bruise. This can lead to life-threatening complications, such as an increase in intracranial pressure, or multiple disorders or failures of the nervous system and requires immediate surgical treatment.

However, bruising can occur repeatedly without any prior apparent trauma or injury pattern. In these cases, a possible blood clotting disorder should always be considered. In these cases, especially in children, one should pay attention to family-related coagulation disorders and initiate further diagnostics.

The presence of newer and old bruises without previous trauma, in combination with behavioral disorders or broken bones in various healing stages can also be indications of physical abuse. They cannot be overlooked.


In most cases, the diagnosis of a bruise can be easily made on the basis of the history of its development, appearance and accompanying symptoms. The color, the extent of the swelling and the extent of the hematoma provide good information about the severity and age of the hematoma. Particularly large-area hematomas that occur in the head area or hematomas in small babies should be given adequate attention and consult a doctor for further assessment. In order to assess the exact size, extent and possibly other additional injuries, additional imaging methods such as ultrasound or computed tomography can be used.

Concomitant symptoms

Bruising is usually accompanied by swelling of the affected tissue. Children usually bother them a little more than adults because they can be very painful depending on their size and spread. Small, fairly superficial bruises usually only cause slight tenderness, which usually disappears after 1-2 days.

Slightly larger bruises that are deep down can sometimes be accompanied by severe pain. If they are located close to organs, they can restrict their function and exert a pressure that is perceived as extremely unpleasant. In addition, the pressure on the surrounding tissue can also lead to narrowing or compression of other blood vessels or nerve tracts. As a result, there is a risk of so-called necrosis, tissue destruction, or disorders of sensitivity and motor skills.

Bruising in children usually shows up externally mainly as a bleeding under an intact skin surface, which initially appears reddish to bluish and changes to greenish or yellowish after one or two days. When the bruise loses its color, this is the first sign of the ongoing healing process.

Particularly large bruises that do not heal as quickly are also a suitable nutrient medium for germs and bacteria, so that when a new fever occurs or signs of inflammation increase (redness, swelling, overheating, pain, impaired functionality), this is accompanied by exhaustion or worsening of the general condition , also always has to think about a spreading infection.


In most cases, bruises in children do not require extensive treatment. Small, superficial bruises that do not cause serious symptoms are usually treated conservatively. One can simply wait for the bruise to heal on its own after a few days or weeks and the discoloration of the tissue to fade.

The whole thing can be supported by cooling the affected tissue and adequate pain medication. The cooling not only reduces the swelling, it also causes the blood vessels to contract and therefore less blood to leak out. In addition to cooling compresses and special cooling pads, ointments such as heparin are often used. This prevents the bruise from expanding further.

Physical protection of the affected area for the time being can also prevent the effusion from spreading further. Elevating the affected extremities can provide additional relief from the symptoms. If, for example, a bruise has accumulated in a joint as a result of trauma, it often makes sense to immobilize it with the help of a bandage.

If a particularly large bruise develops, displacing the surrounding tissue or organs, surgical relief may be necessary in some cases.

Read more on this topic at: How do you treat a bruise?


A bruise usually doesn't last long. It usually subsides completely after a few days. As the bruise heals, it changes color and spread. Initially it appears reddish and then turns into bluish. After 2 - 3 days, when the breakdown process begins, it turns yellowish to greenish, until it finally fades and disappears without leaving any residue. Bruises that accumulate in deeper regions of the body are often very painful because the blood that has leaked out presses on the surrounding tissue. They also take a long time to heal completely.

Bruising in the child after birth

A bruise in the baby after birth is a common and usually harmless consequence of vaginal birth. Since the child has to pass through the often very narrow birth canal of the mother and overcome some bottlenecks, individual parts of the body are often traumatized, which become visible in the form of small bruises after the birth. These usually heal on their own after a few days and do not require a major follow-up check. A special type of bruise that occurs when pressing through the birth canal or when using forceps or suction cups is the cephalhematoma. This is a bluish to red swelling of the head, which also regresses on its own in the course of the process.

Read more on the topic: Head hematoma

Bruising by localization

On the head

Bruises in children that are located in the head area should always be given sufficient attention, as bruises on the head can quickly be accompanied by a concussion. Therefore, the affected children should always be examined thoroughly in order to detect possible abnormalities such as nausea, dizziness, headache or changes in vision. In the case of particularly large bruises, the risk of a possible internal cerebral hemorrhage or an increase in external pressure on the brain should always be considered.

On the arm

In most cases, bruises on the arm occur as a result of a fall or accident. They are not of great disease value and usually heal on their own after a few days to weeks. In children, however, you should pay particular attention to the location of the effusions and whether they appear isolated or bilateral and symmetrical. In some cases, bruises on the extremities, especially at different stages of healing, can indicate the presence of abuse.

On the tongue

In the event of falls and minor mishaps, children often run the risk of biting their tongues. It is usually found very uncomfortable. In addition to an unpleasant, annoying feeling, the affected children often complain of stabbing pain and problems swallowing and eating. The fastest and most effective relief is usually achieved through cooling measures.

On the gums

Bruising on the gums can quickly develop in children as a result of slight falls or carelessness. Because the gums and oral mucosa are very well supplied with blood and are supplied by many nerves, the bruises in these areas are very painful and annoying. In addition, severe swelling in the mouth area leads to a restriction in fluid and food intake.

In the eye

Bruises on and in the eye in children should be examined more closely in order to rule out possible accompanying injuries to the eyeball or eyesight. In the case of particularly strong swellings, there is a risk that too much pressure is exerted on the eye and that the optic nerve may be compressed and, as a result, reduced or, in the worst case, loss of vision.

Read more on this topic at: Bruise in the eye