A cephalohematoma is a collection of blood that forms under the scalp of a newborn, usually after a difficult or assisted delivery. It looks like a soft bump on the baby's head, but it sits above the skull bone and does not affect the brain. Most cases heal on their own over weeks to months.
What is a newborn cephalohematoma?
A cephalohematoma happens when small blood vessels between a baby's skull bone and its covering (the periosteum) break during birth. Blood slowly pools in that space, creating a raised, often firm bump that a parent may first notice a few hours or days after delivery.
Because the bleeding sits on top of the bone and stays contained by the periosteum, the swelling never crosses the natural seams (sutures) of the skull. This is a helpful clue doctors use to tell it apart from other kinds of birth-related head swelling. Importantly, a cephalohematoma is outside the skull. It does not touch the brain, and on its own it does not cause brain damage or developmental delay.
Parents often worry because anything involving a baby's head feels frightening. The reassuring truth is that a cephalohematoma is a common, well-understood, and usually harmless finding. Your care team will watch it closely, and in most cases the body reabsorbs the blood without any treatment at all.
Related Blog: The Role of Physical Therapy in Cephalohematoma Rehabilitation
Cephalohematoma vs. Caput Succedaneum vs. Subgaleal Hemorrhage
Three types of head swelling can appear in newborns, and they are easy to confuse. Telling them apart matters because one of them, a subgaleal hemorrhage, can be serious and needs urgent attention.
How to tell them apart
A caput succedaneum is simple swelling of the scalp from pressure during delivery. It is soft, puffy, may look bruised, and crosses the suture lines. It is present at birth and usually fades within a few days.
A cephalohematoma is firmer, well-defined, does not cross suture lines, and often becomes more noticeable in the first day or two after birth.
A subgaleal hemorrhage is bleeding in a larger, looser layer of the scalp. Blood can spread widely and, unlike the others, is not limited by sutures. Because this space can hold a lot of blood, it may lead to significant blood loss.
Which needs urgent attention
Caput succedaneum and cephalohematoma are generally low-risk and monitored. A subgaleal hemorrhage is the one that can become a medical emergency, because a baby can lose enough blood to affect circulation. Newborns with this condition are watched very closely in the hospital.
| Feature | Caput succedaneum | Cephalohematoma | Subgaleal hemorrhage |
|---|---|---|---|
| Location | Scalp skin/soft tissue | Between skull bone and its covering | Loose layer beneath the scalp |
| Crosses suture lines? | Yes | No | Yes |
| Feel | Soft, puffy | Firmer, well-defined | Boggy, may shift and spread |
| Timing | Present at birth | Appears/grows over 1–3 days | Can develop and expand after birth |
| Typical concern level | Low | Low to moderate | Higher — can be serious |
| Usual course | Fades in days | Reabsorbs over weeks to months | Needs close monitoring/urgent care |
How common is it, and what causes it?
Cephalohematomas are among the more common birth-related findings, especially after deliveries that require extra help. The bleeding comes from the pressure and shearing forces a baby's head experiences while passing through the birth canal.
Assisted delivery & risk factors
The most consistent link is with assisted (instrumental) delivery, such as the use of forceps or a vacuum extractor. These tools apply pressure to the baby's head, which can rupture the tiny vessels beneath the periosteum. Other factors that may raise the chance include a larger baby, a smaller or narrow birth canal, and a first pregnancy. If your delivery involved any of these, a cephalohematoma is a recognized possibility your care team already knows to watch for.
Prolonged labor
A long or difficult labor, or a baby's head staying pressed against the pelvis for an extended time, can also contribute. The prolonged pressure increases the strain on those small blood vessels. None of these causes mean anything was done wrong. They reflect the normal, sometimes challenging, mechanics of birth.
Symptoms & red flags — when to worry
The main sign is a bump on one side of the top or back of the baby's head. It may feel firm at first and become softer in the center as it begins to heal. The skin over it usually looks normal, without a break or open wound.
Most cephalohematomas cause no symptoms beyond the visible bump. However, because a large amount of blood can sometimes be involved, or because the breakdown of blood releases a pigment called bilirubin, some babies develop jaundice (a yellow tint to the skin or eyes).
Seek prompt or urgent medical care if you notice:
- Rapidly increasing swelling, or swelling that spreads across the whole head
- A baby who is unusually sleepy, difficult to wake, pale, or feeding poorly
- Worsening yellow color of the skin or eyes
- Fever, redness, warmth, or drainage over the bump (possible infection)
- Any seizure-like movements or a bulging soft spot
These red flags are uncommon, but they are worth knowing. When in doubt, call your pediatrician or seek care right away.
Diagnosis
In most cases, a doctor diagnoses a cephalohematoma with a simple physical exam. The classic finding, a firm bump that does not cross the skull's suture lines, is usually enough. Your provider will also check for jaundice and monitor feeding and alertness.
Imaging is not routinely needed. If the swelling is unusually large, the story is atypical, or there is concern about the skull beneath it, a doctor may order an ultrasound, X-ray, or CT scan. Rarely, a cephalohematoma occurs alongside a linear skull fracture, which typically heals on its own but may prompt closer observation. A referral to a pediatric specialist, such as the team at NJPNI, can help when parents want expert reassurance or when imaging raises questions.
Treatment & management
The guiding principle is patience. Because the body is very good at reabsorbing this trapped blood, active treatment is the exception, not the rule.
Watchful waiting
For the large majority of babies, the best approach is careful observation. Your pediatrician will monitor the size of the bump, watch for jaundice, and confirm your baby is feeding and growing well. There is no need to drain the swelling in typical cases, and draining is generally avoided because it can introduce infection.
When treatment is needed
Treatment steps are reserved for specific situations. Significant jaundice may be managed with phototherapy (light therapy). If a baby loses enough blood to matter, or if infection develops, targeted medical care is provided. Drainage is uncommon and considered only in select cases by a specialist. These decisions are always individualized.
Calcified cephalohematoma
Sometimes, instead of fully reabsorbing, the outer edge of a long-standing cephalohematoma hardens as calcium deposits form. This is called a calcified cephalohematoma, and it may leave a firm ridge or bump that persists for months. Many calcified cephalohematomas gradually remodel and flatten as the skull grows. In select cases where the deformity is large or lasting, a pediatric neurosurgeon may discuss surgical options. If you are concerned about a persistent hard bump, this is a good reason to consult a specialist. Some families also explore physical therapy for cephalohematoma rehabilitation as part of a broader plan, guided by their care team.
Will rubbing help?
Many parents ask, will rubbing a hematoma on a baby's head help it go away faster? The answer is no. Rubbing or massaging the bump does not speed reabsorption and can be uncomfortable or even cause harm. The safest approach is to leave it alone, keep the area clean, handle your baby normally, and let the body do its work. Always follow your own pediatrician's guidance.
Healing time & prognosis
The outlook for a cephalohematoma is excellent. Most resolve on their own, typically over the course of several weeks to a few months, as the body gradually breaks down and reabsorbs the blood. You may notice the center softening first while the rim stays firm for a while, which is a normal part of the healing sequence.
The long-term prognosis is very reassuring: an uncomplicated cephalohematoma does not cause brain injury, developmental delay, or lasting harm. Conditions that involve the brain or skull shape, such as hydrocephalus, craniosynostosis, or cerebral palsy, are separate issues and are not caused by a simple cephalohematoma. If your child's bump behaves as expected, you can feel confident about their development.
When to see a pediatric specialist (NJPNI)
Most cephalohematomas never need more than routine pediatric follow-up. Still, some situations benefit from specialist input: a bump that is growing rather than shrinking, one that stays hard for many months, an unusual head shape, or simply a parent who wants expert peace of mind. Our pediatric neuroscience team can examine your baby, review any imaging, and explain what to expect in plain language, with no pressure.
FAQ on Cephalohematoma
How Long Does a Cephalohematoma Take to Resolve?
The typical cephalohematoma healing time varies from a few weeks to a few months. In most cases, the lump begins to shrink within the first couple of weeks, with full resolution occurring within 3 to 4 months. During this time, it’s essential to monitor the area closely to ensure there are no signs of complications like infection or jaundice.
Will Rubbing a Hematoma on a Baby’s Head Help It to Go Away?
Parents often ask, “Will rubbing a hematoma on a baby’s head help it to go away?” While it may seem like massaging the lump could promote healing, healthcare professionals advise against it. Rubbing the hematoma can irritate the skin and potentially cause further damage, delaying the healing process. The best approach is to follow your doctor’s guidance and give the hematoma time to heal naturally.
What Happens if a Cephalohematoma Becomes Calcified?
In some cases, a cephalohematoma may harden over time, resulting in calcified cephalohematoma. This occurs when calcium deposits form within the hematoma, leading to a firmer, sometimes irregularly shaped lump.
Will a Calcified Cephalohematoma Go Away?
Though calcified cephalohematoma may not completely disappear on its own, the lump can reduce in size over time. In cases where it interferes with the baby’s skull development or causes discomfort, surgical intervention might be considered. However, most calcified cephalohematomas are harmless and do not affect a child’s long-term health.
Monitoring the hematoma and maintaining regular follow-ups with your healthcare provider will help ensure the condition resolves appropriately without complications.
Does cephalohematoma affect the brain?
No. A cephalohematoma forms outside the skull, between the scalp and the skull bone. It does not press on or damage the brain itself. While the bump may look concerning, it typically does not affect a baby’s brain development or cognitive function.
How do I know if my baby’s bump is serious?
Most cephalohematomas are harmless and shrink on their own. However, you should contact your doctor if:
- The bump keeps growing after birth
- Your baby is very irritable, unusually sleepy, or not feeding well
- You notice redness, warmth, or discharge (possible infection)
- Your baby shows yellowing of the skin or eyes (jaundice)
When should I see a doctor for cephalohematoma?
Always mention the bump during your baby’s first pediatric check-up. Seek medical care immediately if the lump becomes firm and doesn’t shrink, your baby has signs of jaundice, anemia (pale skin, tiredness), fever, or if you notice any sudden changes in behavior. Regular monitoring by a pediatrician ensures safe healing.
Can cephalohematoma cause long-term issues?
In most cases, cephalohematomas heal completely within a few weeks to months without leaving any lasting problems. Rarely, a large or untreated cephalohematoma can lead to:
- Calcification (hardening of the lump)
- Mild skull shape irregularities
- Increased risk of anemia or jaundice during infancy
- Long-term developmental or neurological problems are extremely rare.
