You are called to assess a 4 hours old baby boy in the newborn nursery.  The infant has been born at 40 weeks gestation.  The mother is a 30 year old G2P1 woman whose immunizations are unknown and prenatal serologies are protective. Group B streptococcus swabs were negative. The mother smoked, drank no alcohol throughout the pregnancy, and took diclectin. The mother had gestational diabetes. The labour was 10 hours in duration with membranes ruptured for 8 hours. Meconium was not present. The baby was born via caesarean section with forceps   

Since delivery, the nurses have noted the infant appeared to have bruising on the body.

On examination the infant has no dysmorphic features and is alert. The weight, length, and head circumference are all at the 25th percentile. The body has bruising on the face.  There is normal colour with normal capillary refill with normal S1 and S2 with no murmur.  Chest exam shows  good air entry with no adventitious sounds and no increased work of breathing.   Abdominal exam is normal. Tone is normal and there is spontaneous movements of all four limbs.   Red reflexes of the eyes are normal.