If your baby was born with a cephalohematoma—essentially, a big bruise underneath their scalp—you have plenty of new parent company.
Cephalohematomas are fairly common—up to 2.5% of all newborns get them. And while they may seem alarming, cephalohematomas are rarely cause for concern. They're usually benign, painless, and temporary. Learn why some newborns develop cephalohematomas, how quickly you can expect one to resolve, and when to be concerned.
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What Is a Cephalohematoma?
A cephalohematoma is a bruise beneath the scalp that forms from increased pressure on a baby's head during birth. Broken blood vessels cause a pocket of blood to form on top of the skull bones.
Sometimes people confuse cephalohematomas with another common, temporary newborn condition called caput succedaneum. Often referred to as a “conehead,” caput succedaneum also occurs when there is increased pressure on a baby's head during delivery. However, caput succedaneum is swelling due to a build-up of fluid, not blood, underneath a baby's scalp.
Cephalohematoma Symptoms
You aren't likely to realize that your baby has a cephalohematoma until the day after you give birth. Cephalohematomas usually take about 24 hours to become noticeable.
Typically, your baby will have a slightly swollen single area on the top or back of their head. The spot may be slightly raised and feel like a squishy, water-filled balloon. It usually springs back upon being gently pressed. With a gentle touch, your baby's cephalohematoma isn't likely to cause your baby discomfort. Unlike a normal bruise, cephalohematomas won't cause a discoloration of the surrounding skin.
Cephalohematoma Causes and Risk Factors
A cephalohematoma is caused by increased pressure on the skull, usually during childbirth. Sometimes, cephalohematomas occur when a baby's head is pushed up against your pelvic bone during labor. Or, they form when tools used to aid delivery cause small tears in the veins just under the scalp.
Risk factors for newborn cephalohematoma include:
Breech (vertex) presentation, when your baby is head-up and feet or bum downInfant macrosomia, when your baby is larger than average (more than 8 pounds, 13 ounces)Instrument-assisted delivery, can include the use of forceps or a vacuumProlonged labor, when your labor is extended over many hours, sometimes due to weak or delayed contractions7 Things That Can Happen During Labor
Cephalohematoma Treatment
Your baby's body should reabsorb a cephalohematoma without any special treatment. Depending on its size, cephalohematomas take anywhere from two weeks to three months to go away.
Often the middle of the hematoma will start to disappear first while the outer rim gets harder from calcium. When the cephalohematoma heals in this way, it sometimes feels like a moon crater. While odd, this is almost always normal and just a sign that the hematoma is slowly fading. Through that period, babies usually don't require special care—just be gentle when running your hands over it during bath time.
Potential Complications
While no treatment is needed for cephalohematoma in most cases, some babies have complications that may require a doctor's help.
Anemia: Because a cephalohematoma may cause a drop in red blood cells, your baby may need supplemental iron through an intravenous (IV) line or fortified formula.Calcification: Very rarely, a cephalohematoma can become completely calcified, requiring surgical intervention.Infection: A fever may indicate that your baby has developed an infection around the cephalohematoma and might need antibiotics.Jaundice: Some babies will have jaundice in the first few days following birth as their liver processes bilirubin, a substance the body creates to replace old red blood cells with new ones. Your baby may be placed under phototherapy lights and receive intravenous (IV) fluids to speed up the process.
Key Takeaways
If you have a complicated delivery, there is a chance your baby will develop a cephalohematoma on their head a day or so after they're born. Most of the time, these spongy spots are painless for your baby and will shrink within several weeks. When complications are possible, they're usually minor, though some babies require special treatment. It's important to keep in frequent contact with your child's pediatrician, who will guide you in monitoring and caring for your newborn's cephalohematoma as it heals.
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