Hello, just curious you mentioned that your niece is often clumsy, take a look at her joints does she appear hypermobile?
meaning does her joints move beyond the normal range of motion? some like to use the term double jointed.. look at her knees, fingers do they bow back beyond 10 degrees?
I ask because there is a rare collagen disorder called Ehlers-Danlos Syndrome one of the signs is they bruise easily.
Many go undiagnosed with EDS for many years before they find out, often times parents of children with EDS are accused of child abuse, but really it is because the child has EDS and no one knows it. You can barely touch them and they bruise.
I myself have EDS and went 30 yrs before I was diagnosed it wasn't until my daughter was 3yrs old when we found out. She was always bruised and still is she is now 10.5yrs old. Three out of five of my children are diagnosed with EDS. You are welcome to visit my EDS Genetic Connection website to read more about it I have some photo's there of EDS in babies, children and adults we look normal but our collagen the glue that holds you together is not. Just keep in mind EDS patients vary in the degree of hypermobility for instance my daughters legs go back farther than my sons, and had to be braced, and for my son he had more hypermobility with his shoulders than his legs yet they both have the same type.
Does she sit in the "W" position often? that is another indicator she may have EDS. Does she have any scars if she does do they look shiny? If you or her mother has any more questions please let me know I would be happy to share more detailed info with you.
http://eds.geneticconnection.freehomepage.com/index.html
you can also visit http://ednf.org
True rule out iron deficiency, but just know if any of the above things I mentioned you do see going on then note that EDS patients have low iron, so my advice to you would be to take her to see a genetic doctor. We see DR.Aughton in Royal Oak Beaumont. I wish I could say the doctors were educated on this condition but unfortunately they are still in the learning process and often can't recognize it well enough to diagnose, which I just don't understand myself because I can see someone in two seconds and know for sure they have it just by looking at them how they move and by touching their skin and joints.
I do know of one pediatrician that is familiar with EDS he is in Port Huron if you want his name, most of them say they know of EDS but they do not know EDS they know only what the text books tell them they don't have the experience and knowledge of how it effects people. Prior to having three babies back to back LOL I was the President of the Great Lakes EDNF Chapter/Support group here in Michigan.
Again Contact me with any questions and yes better to look into it so it is on record.
HTH's
Blessings
R.