Don’t Wonder! Learn When to See a Doctor for Childhood Bruises.

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In this article, Prisma Health’s Leslie Gilbert, MD, offers advice on childhood bumps and bruises. We all know it is a normal part of being a kid but do you know when to be concerned about a bruise? Keep reading to learn more.

“It is normal for children to have flat bruises over their shins and other bony areas, such as their elbows and forearms,” said Dr. Gilbert. “This is just part of healthy play and will resolve normally. Bruises should be a concern when they occur in areas such as the back, stomach or bottom, when they occur without any known trauma or when they are not flat.”

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If your child is experiencing these types of bruises, they could be a sign of a bleeding disorder. Bleeding disorders are a group of diseases that lead to an increased risk of bleeding and bruising. A bleeding disorder affects the way your blood would normally clot.

Symptoms of Bleeding Disorders in Children

Dr. Gilbert said individuals with bleeding disorders can experience certain symptoms, including:

  • Increased and spontaneous bruising
  • Increased nose bleeds
  • Petechiae (small red dots on the skin)
  • Bleeding after dental or surgical procedures
  • Frequent and prolonged nosebleeds
  • Heavy menstrual periods

“Diagnosis of a bleeding disorder can often be missed or delayed as symptoms may just be classified as ‘easy bruising’ or ‘easy bleeding’ without further evaluation,” said Dr. Gilbert.

Prisma Health | Jan 2023

While some bleeding disorders develop over time, others are hereditary. Some individuals with certain bleeding disorders are encouraged to follow activity restrictions to avoid severe injury and bleeding, including avoiding contact sports such as football.

When to Have Your Child’s Bruises Evaluated

Dr. Gilbert said a child who persistently has large, knotted bruises (hematomas) that occur without any known trauma should be evaluated. If your child’s bruises are associated with other bleeding symptoms such as nosebleeds that are frequent and prolonged, gum bleeding, heavy menstrual periods, history of increased bleeding after surgery or a procedure, then you should talk to your primary care doctor.

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Diagnosis and treatment are key for managing bleeding disorders,” said Dr. Gilbert.

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Leslie Gilbert, MD MSCI joined the Upstate’s pediatric hematology oncology group at Prisma Health Children’s Hospital in 2015 after completing her pediatric residency at Levine Children’s Hospital in Charlotte, North Carolina and pediatric hematology oncology fellowship at Vanderbilt University Medical Center in Nashville, Tennessee. She also completed a Masters of Science in Clinical Investigation at Vanderbilt University. She is board certified in general pediatrics and in pediatric hematology oncology. In addition to taking care of pediatric patients with oncology diagnoses, she has a special interest in bleeding disorders and vascular malformations. She serves as the medical director of the South Carolina Hemophilia Treatment Center in the Upstate.

About the Author
As South Carolina's largest private, non-profit healthcare system, Prisma Health is here to create a better state of health for South Carolinians.

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