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What Is Cephalohematoma? Causes, Outlook & More

Updated

9/22/2020

Table of Contents

A cephalohematoma is an accumulation of blood that collects between the skull and the scalp of newborns. The most common cause of cephalohematoma is undue trauma or force on the infant’s head. Cephalohematoma is characterized by a soft, bulging area on the back of an infant’s skull.

The outlook for infants with this condition is generally positive. Cephalohematoma does not usually cause brain damage because the blood is pooled on top of the skull.

However, babies born with cephalohematoma may be at risk for certain medical conditions, including jaundice, infection, and anemia. These can be serious and even life-threatening if untreated or if the baby has other health issues.

Causes of Cephalohematoma

Cephalohematoma is considered a birth injury that occurs during labor and delivery. It is often caused by the infant’s head pressing against the mother’s pelvis and/or squeezing through the birth canal. This pressure causes delicate blood vessels to burst, forming the unusual bulge at the back of the skull.

All infants are at risk for cephalohematoma, but it is more likely to occur in certain situations, including:

  • Delivering twins or triplets
  • Infant’s head is too large for labor and delivery
  • Prolonged or difficult labor
  • Birth-assisting devices (forceps or a vacuum)
  • Breech or other abnormal birth positions
  • Weak uterine contractions that slow labor and delay infant’s progress to delivery

Between one and two percent of all babies develop cephalohematoma, although boys are more likely to be affected than girls.

Cephalohematoma Versus Caput Succedaneum

Sometimes people confuse cephalohematoma with a less serious birth condition called caput succedaneum. Caput succedaneum occurs with the natural pressure of a baby’s head passing through the birth canal. Many newborns have a slightly bulbous head that appears swollen for the first few hours or days after birth.

Unlike caput succedaneum, cephalohematoma is caused by burst blood vessels that cause swelling underneath the scalp. Cephalohematoma may take several months to resolve. In rare situations, doctors must drain the fluid if the bulging becomes more pronounced or does not gradually decrease in size on its own.

Outlook for Infants with Cephalohematoma

The outlook for newborns who develop cephalohematoma is generally positive. Cephalohematoma is usually diagnosed by the bulge on the back of the skull. This bulge may be noticeable at birth or develop a day after birth. However, your doctor may request additional tests, including:

  • X-ray
  • Ultrasound
  • Computer topography (CT) scan

Your doctor may recommend that you take pictures or measurements of the swelling. You should get immediate medical care if your infant develops a new bulge or if the bulge gets bigger.

Common Treatment for Cephalohematoma

Often there is no specific treatment after cephalohematoma is diagnosed, other than watchful waiting to ensure the swelling gradually decreases.

You may notice certain characteristics and changes, such as:

  • The bulge may feel firmer as the blood calcifies and is reabsorbed in the body.
  • The center of the bulge may dissipate before the sides for a crater-like appearance.
  • It may take up to three months for the swelling to completely subside.

If you notice that your baby has trouble feeding, or does not develop according to normal benchmarks, call your healthcare provider.

Complications of Cephalohematoma

Cephalohematoma may increase your baby’s risk for certain medical conditions, including:

  • Anemia: Your baby lacks enough healthy red blood cells to carry needed oxygen to bodily organs and tissue.
  • Jaundice: Your baby has a build-up of bilirubin, meaning that the liver is not efficiently processing red blood cells.
  • Infection: Your newborn may be at greater risk of infection, particularly if the fluid must be drained.

Your baby may be anemic if he or she has trouble breathing, has unhealthy skin tones, or has an abnormally fast heartbeat. Some babies with anemia need a blood transfusion to maintain healthy oxygen levels.

Jaundice causes the skin and even the whites of your infant’s eyes to become yellow. Your doctor may want to check your baby’s liver function for abnormalities.

How Cephalohematoma May Be Avoided

Like other types of birth injuries, cephalohematoma is often caused by medical providers who fail to uphold accepted levels of care.

Your baby’s cephalohematoma may have been avoided with:

  • Greater oversight of your baby’s size and weight, since overly large infants are more prone to this condition
  • Delivering by Cesarean or C-section to avoid rupturing blood vessels
  • Correct use of birth-assisted devices such as vacuum or forceps
  • More careful handling of baby during delivery
  • Better monitoring of uterine contractions that can prolong labor

Cephalohematoma is caused by a birth injury that may affect your baby’s health outlook. You should not have to suffer financially from medical malpractice or neglect.

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