Did you know that small, apparently insignificant injuries such as bruises or mouth injuries in young infants are often from child abuse?

These seemingly trivial injuries are known as “sentinel injuries,” because they should not be found in a baby who is unable to pull to a stand and take a few steps. Sentinel injuries are so minor that explanations about their causes being accidental may seem completely plausible and believable. But injuries that are common in walking children should not be present in infants who are not yet able to walk. Babies who are not cruising should not be bruising.

Sentinel injuries are early warning signs that, when recognized and responded to, may prevent future, more severe injuries to a child. A sentinel bruise is a bruise present anywhere on an infant’s body. Even a tiny bruise can be an indication of a problem.

Mouth injuries in young infants are often caused when an angry or frustrated caregiver “rams” something into the infant’s mouth, causing injury to the frenulum under the tongue or upper lip or to other soft tissue in the mouth. Non-mobile infants rarely have any bruising and never have mouth injuries, burns or broken bones from normal care and normal activities.

Sentinel injuries are not limited to infants. Please seek medical attention or make a report for an infant with bruising or other small injuries. Doing so can lead to early detection of a possible medical problem or may prevent the escalation of abuse.

Please be aware of these early warning signs and report any concerns for child abuse or neglect to child protective services and/or law enforcement.

If you would like to make a child abuse referral, please call

or your local law enforcement agency.