Background: The clarification of unclear bleeding in suspected child endangerment with the differential diagnosis of a possibly underlying coagulation disorder but also of other diseases with a bleeding tendency and the interpretation of the necessary wide range of laboratory findings are always great challenges for specialists. Objective and method: As part of a Delphi process 15 recommendations for hemostaseological assessment and diagnostics in the case of nonaccidental bleeding symptoms were agreed upon by the members of the Standing Committee on Pediatrics of the Society for Thrombosis and Hemostasis Research (GTH) and complement the S3 guidelines of the Association of the Scientific Medical Societies in Germany (AWMF) on child abuse and neglect. Conclusion: Consensus (≥ 75% agreement) could be achieved for 14 recommendations. A standardized anamnesis and further diagnostics should always be carried out. Mild acquired or congenital coagulation disorders do not lead to life-threatening bleeding, such as cerebral hemorrhage, either spontaneously or as part of minor trauma. The retinal hemorrhages typical for shaken baby syndrome are not a symptom of congenital or acquired coagulation disorders.