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When Parents Should Worry about Bumps and Bruises

Posted on Oct 19, 2020

What can cause some of the bumps and bruises on a child? Ebony Hunter, M.D., is a pediatric emergency medicine physician at Johns Hopkins All Children’s Hospital. On this week’s On Call for All Kids, she helps parents understand about bumps and bruises and when to be concerned. 

So many things can cause bumps and bruises on your child. Insect bites and trauma are the main two reasons we see children for bumps and bruising. 

Regarding insect bites, what should parents do if their child gets one, or two, or many?

First and foremost, cleanse the area as soon as you notice the bite. You can clean with soap and water. You can apply a topical over-the-counter anti-itch cream such as hydrocortisone if your child is having severe itching and there are not contraindications. However, do not apply these creams around eyes, mouth or genital areas. Try to prevent the child from scratching. You may have to clip his or her nails really short to help with this.

Can insect bites get infected? 

Absolutely! If you start noticing redness, swelling, warmth, increased pain and yellow fluid from the area, then it may be getting infected. I would recommend a health care provider look at it if your child is experiencing those symptoms so that he/she can determine if it is infected or not. 

How can parents prevent insect bites? 

You can use a repellent. There are multiple types of repellant available. Some are DEET based and some are essential oil based/natural. If you have reservations about applying DEET frequently to your child, then you can choose the natural essential oil-based repellent. Both work well. 

What about bruising? What can cause that? 

Usually any type of trauma to the body can cause bruising. Kids can bump a table or fall and obtain a bruise. 

When should parents become worried? 

If you notice a laceration/cut that has the skin separated, your child may need stiches. I would want a health care provider to look at that. Also, if you notice any deformity in the shape of the bone or the child refuses to use that area of the body, I suggest bringing the child in. The child may have a broken bone underneath the bruise. 

What should we do for bruises that seem mild?

Rest the area, ice if your child allows it and elevate it. Trying to get a child to rest and ice an area can be difficult. For mild discomfort, you can give over-the-counter pain medication such as ibuprofen or acetaminophen if your child has no other contraindications to these medications. We do not recommend you ever give a child under 18 aspirin, however.

How long will bruising last? 

Usually the bruising will get worse over the first 48 hours and turn various colors of red, blue, purple depending on your skin pigmentation. There may be some initial swelling that improves over the first 24 hours. Bruises usually take about one to two weeks max to fade. 

Are there any bruises that parents or caregivers should worry about immediately? 

Unfortunately, yes. Any bruise on a non-mobile (meaning not walking not crawling) baby is worrisome. Ear bruising and bruising in the genital area are always concerning. Any child with frequent unexplained bruising. I would recommend the child be brought to the emergency department immediately if you notice these. Also, if you notice that your child is starting to frequently bruise more so than previously recognized with normal day play and activities, that may be an indication or underlying illness and needs to be assessed. 

On Call for All Kids is a weekly series featuring Johns Hopkins All Children’s Hospital experts. Visit HopkinsAllChildrens.org/Stories each Monday for the latest report.


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