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Why does my 18-month-old bruise so easily?
Q: My 18-month-old is bruising very easily, sometimes from a firm touch. What is this a symptom of?
A: Kendra, it’s good that you’re observing your daughter’s skin closely.

Bruising is caused by small amounts of bleeding from the blood vessels just under the surface of the skin. Your 18-month-old daughter is at the age that most children get a lot of bruises. Starting from the time they’re learning to walk until about 4 years of age, young children spend a lot of time walking, running, climbing, and falling. Although their baby fat helps cushion the bumps a bit, it’s common for toddlers to have many bruises on their knees, shins, elbows, and foreheads.

Although most bruising in toddlers is completely normal, you seem concerned that your daughter may bruise exceptionally easily. Are there other family members with bruising or bleeding problems? Is your daughter basically healthy, other than the bruising, or does she seem to have other health problems? Does she have unusual looking bruises like many purple dots, large expanding bruises, or bruises on unusual parts of her body? Have you noticed that it’s hard to stop her bleeding from small scrapes or a bloody nose? Does she have swollen and tender joints? Does she appear ill, pale, and lethargic? These are possible signs of uncommon blood disorders that can interfere with blood clotting.

Be sure to talk with your pediatrician about your concerns about your daughter’s bruising. The doctor can examine her bruises and maybe do some blood tests. If it looks like there’s a problem, you may be referred to a pediatric hematologist (blood specialist) for diagnosis and treatment.
Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician