About Haemophilia
Haemophilia is an inherited bleeding disorder in which the blood does not clot properly due to a deficiency of specific clotting factors.
Haemophilia A (factor VIII deficiency) is the most common form, followed by haemophilia B (factor IX deficiency). The condition primarily affects males, though females can be carriers and may sometimes experience symptoms. Severity ranges from mild to severe, depending on the level of clotting factor present.
Most children with moderate to severe haemophilia receive regular prophylactic (preventive) treatment, typically through intravenous infusions of clotting factor. Newer treatments, including extended half-life products and subcutaneous therapies (such as emicizumab), have made treatment more manageable for many families. An Individual Healthcare Plan should be developed with the family and the child's haemophilia team.
How Haemophilia May Affect a Pupil
- Bleeding episodes, which may be caused by injury or occur spontaneously (particularly in severe haemophilia)
- Joint bleeds, causing pain, swelling and restricted movement (most commonly in knees, ankles and elbows)
- Muscle bleeds, causing pain and limited function
- Bruising more easily and extensively than other children
- Absences for hospital appointments, treatment or recovery from bleeds
- Joint damage over time if bleeds are not treated promptly
Classroom and School Strategies
Safety and First Aid
- Ensure all staff know which pupils have haemophilia and understand the basic first aid response
- Follow the pupil's IHP for guidance on when to contact parents and seek medical attention
- Treat all head injuries seriously, even if the child seems fine; contact parents and follow the IHP
- Apply ice (wrapped in a cloth) to bumps and bruises promptly
- Keep a record of all injuries and inform parents at the end of the day
- Avoid aspirin and ibuprofen; paracetamol is the preferred pain relief
Physical Education and Activity
- Encourage participation in PE and physical activity; exercise strengthens muscles and protects joints
- Follow advice from the haemophilia team about any specific activity restrictions
- Contact sports with high collision risk (e.g. rugby, boxing) may need to be avoided or adapted
- Swimming is generally an excellent activity for children with haemophilia
- Ensure the pupil warms up properly before exercise
- Watch for signs of a joint or muscle bleed during or after activity (pain, swelling, reluctance to move a limb)
General Support
- Be flexible with attendance and deadlines if the pupil has had a bleed or been in hospital
- The pupil may arrive at school in pain or with restricted movement; allow rest and adapted activities
- Be discrete about the condition; the pupil may not want peers to know
- Avoid overprotection; support the child's independence and participation
- Provide a buddy system in the playground for younger pupils to help reduce accidents
- Ensure the environment is as safe as reasonably possible (e.g. padded edges on sharp furniture for younger children)
Further Information and Resources
The Haemophilia Society provides schools guidance, factsheets and support.
NHS information on haemophilia offers accessible medical information.