Alexei's safety and overall well-being was a matter of double importance. Not only was he the eldest son of an Emperor, but he was also the only male issue. His sisters couldn't inherit the throne because of the Fundmaental Laws of Succession, and after Alexei only one other male was left in Alexander III's line, his uncle Mikhail. So from his birth Alyosha was forced to live a very closely guarded life. Given the circumstances, it was easy to make a mountain out of a molehill...

At 11 o'clock I took the children to church. We lunched alone. Alix and I were very worried because little Alexei started bleeding from the navel, and it continued on and off until the evening! We had to send for Korovin and the surgeon Feodorov; at about 7 o'clock they applied a bandage. The little one was remarkably calm and gay! How painful it is to live through such moments of anxiety!
~Nicky's Diary, 8 September, 1904~

Alexei was only 5½ weeks old when his parents were alerted to the blood coming from his navel. Nicky recorded everything in his diary diligently, the bleeding started in the afternoon and lasted until evening. When the bandage was removed the next day dried blood was found, and to everyone's relief he showed no signs of continued bleeding.

His parents were concerned, neither had any idea about what this meant, even their doctors couldn't give them a good explanation. Pædiatricians today, however, know that umbilical bleeding is quite common in infants. They suggest keeping the navel as clean as possible to prevent this from happening.

For the start of his life Alexei lived out a normal childhood. He rough-housed with his sisters during their summer cruises, he liked to be tossed from a hammock onto a big pile of straw, and especially loved winters when he could play in the snow drifts. He had two companions: Klim Nagorny and Dina Derevenko, both the Tsar's sailours. They watched over him as personal bodyguards, making sure Alexei stayed safely out of harm's way. It was their job to spot accidents before they happened.. sometimes when Alexei fell a rather large bruise would appear.

More and more his activities were shielded. A fall or a bump, the Family was finding out, could potentially be dangerous. As Alexei grew older some of his falls turned into painful episodes, he was bruising too easily and it took a while for him to heal. A particular episode at the end of 1907 brought the child to a weak state, and paled with pain he was sent to bed.

Not every bruise Alexei had became a problem. He would stub his toe and not be able to fit his boot on for a while.. but he simply waited until the swelling would go down and then resume his normal activities.

All active, young boys have bumps and bruises.. Alexei was a perfectly normal kid in this respect. His problem wasn't even considered life threatening until he was 8 years old. The Spala Episode, October 1912, was a turning point in his life. There was no doubt, something was very wrong with him.

If only the doctors could figure out what.