Safeguarding Non-Mobile Babies

Bristol Safeguarding Children Board have finalised the ‘Multi-Agency Guidance for Injuries in Non-Mobile Babies’, which all Early Years Settings and Childminders have to follow.

It was developed in response to the tragic death of a 17 week old baby and subsequent South Gloucestershire Serious Case Review in 2014 with the aim of ensuring that non-mobile babies presenting with bruises or injuries are seen quickly and by
appropriately trained staff .

The serious case review noted that: ‘Bruising in babies who are not independently mobile is very uncommon (under 1%). Bruising in a baby who is not yet crawling, and therefore has no independent mobility, is very unusual.’ The review produced 5 themes and a total of 12 recommendations. It looked at safeguarding and the presence of injuries or incidents in non-mobile infants and found:

  • ‹A bruise should never be interpreted in isolation and must always be assessed in the context of the child’s medical and social history, developmental stage and explanation given.‹
  • Any injury or unusual presentation in a non-mobile infant should be seen promptly by a clinician experienced and trained in examining small infants.
  • Inflicted and neglectful causes must always be considered in the differential diagnosis, even if an accidental explanation is very plausible.

‘Those who don’t cruise, rarely bruise’, NICE Clinical Guidance.

A key recommendation from the serious case review has led to development of multi agency guidance in Bristol and South Gloucestershire and the “Multi Agency Guidance for Injuries in Non-Mobile babies” is available from the BSCB website:


Addendum for Early Years Settings and Childminders

To make it clear what childcare settings should do, BAND has helped develop an ‘Addendum for Early Years Settings and Childminders’, to supplement and work alongside the multi-agency protocol. This should be included in settings’ Safeguarding policies and procedures and is available from BAND and the BSCB.

Download the Addendum, Guidance & Body Map documents here :

Addendum for Early years March 2016 

Band guidance Non mobile babies

Body Map 2016

Early Years Workers and Childminders must ensure that any non-mobile baby seen with bruises or injuries is seen immediately by a community paediatrician and that checks are run to ascertain if the baby or family are known to Social Care via First Response, as this will inform any risk assessment carried out by the paediatrician.
Noting birth marks or birth trauma marks on body maps has begun to happen in local maternity hospitals. This will be included in babies’ “Red Books” and is something that settings could request or, if not given, complete when a new baby joins your setting.

This will avoid any misunderstandings about existing marks and can be easily checked. BAND has a baby body map which groups can use. If a baby is brought into a setting with an injury, and the family tell you that the child has already been seen by the Community Paediatrician and they do not have any proof of the visit, such as a letter, you need to check with First Response / Social Care that the baby was seen.

If a non-mobile baby is seen with a significant injury or with bleeding from the nose, mouth and / or ears they must be seen straight away without delay usually by calling 999.

On-Call Consultant Paediatrician (via BRI Switchboard) T: 0117 923 0000
First Response: T: 0117 903 6444

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