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Protecting children from physical abuse

Last updated: 20 Dec 2023

Physical abuse is defined as deliberately hurting a child and causing physical harm (Department of Health, 2017; Department for Education, 2023; Scottish Government, 2023; Wales Safeguarding Procedures Project Board, 2020). It includes injuries such as:

  • bruises
  • broken bones
  • burns
  • cuts.

It may involve:

  • hitting
  • kicking
  • shaking
  • throwing
  • poisoning
  • burning
  • scalding
  • drowning
  • any other method of causing non-accidental harm to a child.

Physical abuse may also happen when a parent or carer fabricates the symptoms of, or deliberately induces, illness in a child. (Department for Education, 2023; Department of Health Social Services and Public Safety, 2017; Scottish Government, 2023; Wales Safeguarding Procedures Project Board, 2020).

Breast ironing or breast flattening, a practice of using hard or heated objects to suppress or reverse the growth of breasts, is a recognised form of child abuse (Crown Prosecution Service, 2019).


Impact of physical abuse 

Effects on infants

Shaking or hitting babies and very young children can cause:

  • fractures
  • broken bones
  • internal injuries.

Non-accidental head injuries (NAHI) can cause brain injury which can lead to:

  • learning problems
  • behaviour problems
  • seizures
  • hearing and speech impairment
  • visual impairment or blindness
  • changes in personality
  • severe brain damage
  • long-term disability
  • death.

Effects on older children

"My parents fight with each other, and they end up taking it out on me. Every day they argue and shout at me, when they get really angry they hit me and kick me too. They tell me that everything's my fault and they don't want me to be their child. I feel responsible for everything that's going wrong with my family. I'm so scared to be at home, I’m terrified that my parents will hit me again. Usually I leave the house and walk around until my parents find me. The only way I can calm down is to self-harm, I feel so upset and on edge all of the time, I just don't know what to do."

Childline counselling session with a girl aged 16

Children who have been physically abused may experience effects including:

  • behavioural or conduct problems
  • mental health problems such as depressive disorders, anxiety disorders, and eating disorders
  • drug and alcohol problems
  • suicidal thoughts and feelings (Norman et al, 2012).

The psychological impact can last long after their injuries have healed.

Brain development

Physical abuse, as an adverse childhood experience, can have a negative effect on the development of children’s brains, potentially impacting their mental and physical capacities in later life.

The effect of physical abuse on a child’s developing brain can lead to an overactive stress response, impaired cognitive development and weakened executive function skills.

(Shonkoff et al, 2008; Shonkoff et al, 2014).

> Find out more about how trauma and abuse effects children’s brain development


Recognising physical abuse

Bumps and bruises don’t necessarily mean a child is being physically abused – all children have accidents, trips and falls. These injuries tend to affect bony areas of the body such as elbows, knees and shins and aren’t usually a cause for concern. However, some injuries are more likely to indicate physical abuse.

Signs and indicators


  • commonly on the head but also on the ear, neck or soft areas (abdomen, back and buttocks).
  • defensive wounds commonly on the forearm, upper arm, back of the leg, hands or feet.
  • clusters of bruises on the upper arm, outside of the thigh or on the body.
  • bruises with dots of blood under the skin.
  • a bruised scalp and swollen eyes from hair being pulled violently.
  • bruises in the shape of a hand or object
  • bruises on non-mobile babies (babies who cannot crawl, cruise, bottom shuffle or roll over).

> See the Bruises on children: core info leaflet

Burns or scalds:

  • can be from hot liquids, hot objects, flames, chemicals or electricity.
  • these may be on the hands, back, shoulders or buttocks. Scalds in particular may be on lower limbs, both arms and/or both legs.
  • a clear edge to the burn or scald
  • sometimes in the shape of an implement – for example, a circular cigarette burn
  • multiple burns or scalds.

> See the Thermal injuries on children: core info leaflet

Bite marks:

  • usually oval or circular in shape
  • visible wounds, indentations or bruising from individual teeth.

Fractures or broken bones:

  • fractures to the ribs or the leg bones in babies
  • multiple fractures or breaks at different stages of healing.

> See the Fractures in children: core info leaflet

Signs of head injury in an infant:

  • visible signs such as swelling, bruising or fractures
  • unusual behaviour – being irritable, lethargic, unresponsive or not wanting to feed
  • seizures
  • vomiting
  • respiratory problems
  • being comatose.

Not all head injuries are caused by abuse. There are also other medical reasons a baby may have these symptoms.

> See the Head and spinal injuries in children: core info leaflet

Behavioural changes

  • fear of specific individuals
  • flinching when approached or touched
  • reluctance to get changed in front of others or wearing long sleeves or trousers in hot weather
  • depression or withdrawn behaviour. 

Risks and vulnerability factors

Physical abuse can happen in any family. But babies and children who have a disability are at a higher risk of suffering physical abuse (Jones et al, 2012).

> Find out more about safeguarding d/Deaf and disabled children

> Read our How safe? 2020 report for more information about adolescents’ experiences of physical abuse

Some parents may also struggle to provide their children with safe and loving care if they are facing difficulties such as:

  • poverty
  • poor housing
  • substance misuse
  • relationship problems
  • domestic abuse
  • the effects of childhood abuse or neglect.

If parents are isolated and don’t get enough support, things can become even more challenging. The more of these problems a family is facing, the harder it can be to cope – and the greater the risk of harm to children.

Challenges parents or carers may face

Adults who physically abuse children may have:

  • emotional or behavioural problems – such as difficulty controlling their anger
  • health issues which make it difficult for them to cope
  • family or relationship problems
  • experienced abuse as a child (Miller-Perrin and Perrin, 2013).

Responding to physical abuse

Recording concerns

Physical abuse may form a long-term pattern of behaviour. Adults who are concerned a child is being physically abused should record individual incidents to build up an overview of the child’s lived experience. This should then be shared with other agencies as appropriate and used to decide what support a child and their family need.

If a child is frequently injured, and if the bruises or injuries are unexplained or the explanation doesn’t match the injury, this should be investigated. A delay in seeking medical help for a child when it is needed should also be reported.


If you think a child is in immediate danger, contact the police on 999. If you're worried about a child but they are not in immediate danger, you should share your concerns.

  • Follow your organisational child protection procedures. Organisations that work with children and families must have safeguarding policies and procedures in place.
  • Contact the NSPCC Helpline on 0808 800 5000 or by emailing Our child protection specialists will talk through your concerns with you and give you expert advice. 
  • Contact your local child protection services. Their contact details can be found on the website for the local authority the child lives in. 
  • Contact the police.

Services will risk assess the situation and take action to protect the child as appropriate either through statutory involvement or other support. This may include making a referral to the local authority.

> See our information about recognising and responding to abuse

If your organisation doesn't have a clear safeguarding procedure or you're concerned about how child protection issues are being handled in your own, or another, organisation, contact the Whistleblowing Advice Line to discuss your concerns.

> Find out about the Whistleblowing Advice Line on the NSPCC website

When you're not sure

The NSPCC Helpline can help when you're not sure if a situation needs a safeguarding response. Our child protection specialists are here to support you whether you're seeking advice, sharing concerns about a child, or looking for reassurance.

Whatever the need, reason or feeling, you can contact the NSPCC Helpline on 0808 800 5000 or by emailing

Our trained professionals will talk through your concerns with you. Depending on what you share, our experts will talk you through which local services can help, advise you on next steps, or make referrals to children's services and the police.

> Find out more about how the NSPCC Helpline can support you


When you are assessing whether a child’s physical injuries were the result of abuse:

  • consider the injuries in the context of the child’s medical and social history
  • think about whether the explanation for the injury is consistent with the child’s stage of development and the environment where it was said to have occurred
  • check whether the severity of the injury fits with the description of the cause.

In cases of bruising in non-mobile babies, the Child Safeguarding Practice Review Panel (CSPRP) for England recommends that injuries should first be reviewed by a health professional who has the appropriate expertise. This should be followed by a multi-agency discussion about any other information or known risks, which should involve the same health professional (CSPRP, 2022).

See our Core Info leaflets for more detailed information on assessing each type of physical abuse:



Preventing physical abuse

Empowering children and parents

Children of all ages need support to identify the signs of abuse and to speak out if something is wrong. It’s also important that parents and carers know how to keep their children safe.

Parenting advice

Research shows there’s a risk of physical punishment escalating into more severe forms of abuse (Heilmann, Kelly, and Watt, 2015). So it’s important that parents are made aware of the harmful effects of physical punishment and given alternative strategies to use when reacting to challenging behaviour.

Share our parenting leaflets with parents are carers:

Supporting parents and carers

Adults who physically abuse children may never have been taught how best to respond to a child. They may have unrealistic expectations of the way children should behave or lack understanding of a child’s needs.

Early intervention services can help by teaching parents how to respond to a child who is displaying challenging behaviour, for example a crying baby.

NSPCC services

NSPCC provides services to support parents to provide safe and loving care for their families.

Preventing non-accidental head injury training

If you work with babies and their parents and carers, this course will help you to understand what NAHI is, identify risk factors within families, and put support in place to help parents and carers keep their baby safe.

> Find out more about Preventing non-accidental head injury training

Speaking out

It’s vital to build safe and trusting relationships with children so they can speak out about any problems they are experiencing. This involves teaching children what abuse is and how they can get help.

Our Speak out Stay safe service for schools helps children understand abuse in all its forms and know how to protect themselves.

> Find out more about Speak Out Stay Safe

Legislation and guidance

Legislation and guidance about physical abuse

Key legislation

Across the UK, statutory guidance highlights the responsibility of those in the education, community and care sectors to safeguard children from all forms of abuse and neglect.

The law to protect children from physical assault dates back to 1861 (Offences Against the Person Act 1861).

Current child protection laws protect children from physical abuse. But children’s rights campaigners such as the NSPCC continue to call for changes in the law to protect children from physical punishment.

Equal protection from physical assault

The United Nations Convention on the Rights of the Child states that children should be protected from physical and mental violence, including physical punishment (United Nations, 1990 and 2006). But in England and Northern Ireland, children are the only group of people who are not fully protected from physical assault.

These defences can’t be used in cases where a child has suffered serious physical injury (actual bodily harm).

In Scotland, the defence of reasonable chastisement, which allowed parents and carers to justify physical punishment of their child, was abolished under the Children (Equal Protection from Assault) (Scotland) Act 2019. The Act came into force on 07 November 2020.

In Wales, the defence of reasonable punishment, which allowed the physical punishment of children, was abolished in 2022 under the Children (Abolition of Defence of Reasonable Punishment) (Wales) Act. The Act came into force on 21 March 2022. The Wales Safeguarding Procedures Project Board has published guidance on safeguarding responses where a child is affected by physical punishment (Wales Safeguarding Procedures Project Board, 2022).

In the States of Jersey, the Children and Education (Amendment) (Jersey) Law 2020 came into force in April 2020. This abolishes the defence of reasonable corporal punishment of a child.

The Crown Prosecution Service (CPS) provides guidance on prosecuting offences against the person in England and Wales (CPS, 2022). It sets out that the charge should be actual bodily harm unless either:

  • "the injury is transient and trifling and amounted to no more than temporary reddening of the skin"
  • or the incident took place in England, or in Wales, before the 21 March 2022, and the defence of "reasonable punishment of a child" applies.

In England, in cases of common assault, legal professionals are expected to judge for each individual case, whether the punishment was “reasonable and moderate”, taking into account factors such as the age of the child. This means they’re making subjective decisions on the severity of a child’s physical injuries and the pain they’ve experienced, and there could be variations in the extent to which children are protected from assault.

Guidance for medical professionals

The Royal College of Paediatrics and Child Health (RCPCH) has published guidance on the delivery of child protection medical assessments (RCPCH, 2020). The guidance for all UK nations sets out 13 standards to promote equitable, high-standard medical assessments where there are concerns about physical abuse and neglect.

The RCPCH has also published guidance on perplexing presentations (PP) and fabricated induced illness (FII). PP is used to describe situations where there are warning signs that a child might be experiencing FII, but there is no clear physical, mental or neurological diagnosis and practitioners do not think the child is at risk of immediate serious harm.

Keep up to date with new legislation and guidance by signing up to CASPAR, our current awareness service for policy, practice and research.

References and resources

References and resources

Afifi, T.O. et al. (2017) Spanking and adult mental health impairment: the case for the designation of spanking as an adverse childhood experience. Child abuse and neglect, 71: 24-31.

Child Safeguarding Practice Review Panel (CSPRP) (2022) The management of bruising in non-mobile infants paper. [Accessed 28/10/2022].

Crown Prosecution Service (CPS) (2019) So-called honour based abuse and forced marriage. [Accessed 10/09/2021].

Crown Prosecution Service (CPS) (2022) Offences against the person, incorporating the charging standard. [Accessed 21/03/2022].

Department for Education (DfE) (2023) Working together to safeguard children 2023: a guide to multi-agency working to help, protect and promote the welfare of children. [Accessed 15/12/2023].

Department of Health (2017) Co-operating to safeguard children and young people in Northern Ireland. [Accessed 10/09/2021].

Heilmann, A., Kelly, Y. and Watt, R.G. (2015) Equally protected?: a review of the evidence on the physical punishment of children. London: NSPCC.

Jones, L. et al (2012) Prevalence and risk of violence against children with disabilities: a systematic review and meta-analysis of observational studies. Lancet, 380(9845): 899-907.

Miller-Perrin, C.L. and Perrin, R.D. (2013) Child maltreatment: an introduction. London: SAGE.

Norman, R. E. et al (2012) The long-term health consequences of child physical abuse, emotional abuse, and neglect: a systematic review and meta-analysis. PLOS Medicine 9(11).

Royal College of Paediatrics and Child Health (RCPCH) (2020) Child Protection service delivery standards. [Accessed 10/09/2021].

Royal College of Paediatrics and Child Health (RCPCH) (2021) Perplexing presentations (PP)/fabricated or induced illness (FII) in children guidance. [Accessed 10/09/2021].

Shonkoff, J.P. et al (2008) The timing and quality of early experiences combine to shape brain architecture: working paper 5. Cambridge: Center on the Developing Child, Harvard University. 

Shonkoff, J.P. et al (2014), Excessive stress disrupts the architecture of the developing brain: working paper 3. Cambridge: Center on the Developing Child, Harvard University.

Scottish Government (2023) National guidance for child protection in Scotland - updated 2023. [Accessed 20/11/2023].

United Nations (1990) Convention on the Rights of the Child (PDF). London: UNICEF.

United Nations (2006) Convention of the rights of the child:  forty second session, Geneva, 15 May – 2 June 2006. General Comment no.8. [Accessed 10/09/2021].

Wales Safeguarding Procedures Project Board (2020) Wales safeguarding procedures. [Accessed 10/09/2021].

Wales Safeguarding Procedures Project Board (2022) Safeguarding children in relation to the Children (Abolition of Defence of Reasonable Punishment (Wales) Act 2020. [Accessed 24/05/2023].


If a child or young person needs confidential help and advice direct them to Childline. Calls to 0800 1111 are free and children can also contact Childline online or read about physical abuse on the Childline website. You can also download or order Childline posters and wallet cards.


Our elearning courses can help develop your understanding of how to protect children from physical abuse and other abuse types.

Related NSPCC resources

Our Core Info leaflets give more detailed information about recognising the signs of physical abuse: 

> See all our research and resources on physical abuse

Further reading

For further reading about physical abuse, search the NSPCC Library catalogue using the keywords: "physical abuse" "physical punishment".

> Find out more about the Library and Information Service