Does your newborn have a surprising bump on their head? It might be a cephalohematoma, a collection of blood under the scalp that's common during childbirth. While it sounds scary, these usually resolve on their own. This blog dives into the types, causes, effects, diagnosis, treatment, and much more.So relax, take a deep breath, and let's explore what this bump means for your little one.

What is a newborn cephalohematoma?

Newborn cephalohematoma is a condition that can occur in babies due to pressure or trauma to the head during birth. This leads to a collection of blood underneath the scalp, but it does not pose a risk to the baby's brain as it is located outside the skull. The bleeding is slow and can take hours or days to become noticeable. While infant cephalohematoma is common, affecting around 1% to 2% of newborns, it typically resolves on its own without treatment. It is advisable to consult a doctor who may recommend further evaluation by a specialist.

Related Blog: The Role of Physical Therapy in Cephalohematoma Rehabilitation

Types of Newborn Cephalohematomas

While cradling your precious newborn, you might notice a soft lump on their head. This could be a cephalohematoma, a collection of blood under the scalp caused by pressure during delivery.

Here's a breakdown of the different types of cephalohematomas in newborns:

• Early Bird Bumps (Acute Hematoma): These appear right after birth, caused by pressure on the head rupturing tiny blood vessels.
• Delayed Discovery (Chronic Hematoma):  These show up days or even weeks later. Sometimes, an acute hematoma that wasn't noticed initially can develop into a chronic one.

Early diagnosis is crucial for both types. If left untreated, an acute cephalohematoma can develop into a chronic one.

How common is cephalohematoma in newborn?

Cephalohematomas are seen in roughly 2.5% of prolonged and challenging vaginal deliveries. The risk increases to about 1 in 10 babies when an assisted delivery involving vacuum extraction or forceps is needed.

Treatment and management of cephalohematoma

In many cases, newborns do not require any treatment for cephalohematoma as it typically resolves on its own without medical intervention. The bump tends to disappear after a few weeks or months. On rare occasions, a healthcare provider may opt to drain it, but this is not always needed. It's important to observe the area closely for any unusual signs as advised by your doctor.

What are risk factors for newborn cephalohematoma?

Risk factors for cephalohematoma in newborns include:

- Assisted delivery methods like vacuum extraction or forceps

- Use of epidural pain relief during childbirth

- Larger-than-average baby, weighing more than 8 pounds 13 ounces

- Birth of multiple babies, such as twins or triplets

- Prolonged and difficult vaginal delivery

These factors can increase the likelihood of a newborn developing a cephalohematoma.

What are the effects of cephalohematoma?

During childbirth, the pressure on a newborn's scalp can lead to the damage or rupture of small blood vessels, resulting in the accumulation of blood under the scalp. This can create a soft bulge or bump, usually at the back of the head, that resembles a bruise. As time passes, the soft mass may begin to harden or calcify. It often shrinks in the center first, giving it a ring-shaped or crater-like look.

Potential Complications

Potential Complications of Cephalohematoma in newborn:

- Anemia: A cephalohematoma can lead to anemia in babies due to blood loss.

- Calcifications: Cephalohematomas lasting over five weeks may result in calcifications, affecting skull formation.

- Infections: Cephalohematoma increases the risk of infections like osteomyelitis, cellulitis, or sepsis.

- Jaundice: Blood absorption from cephalohematoma can cause jaundice in babies.

- Skull Fractures: Some babies with cephalohematomas may also have linear skull fractures, which typically heal without treatment.

Symptoms of Cephalohematoma

One common sign of cephalohematoma in babies is a soft bulge or bump on the back or top of their head. This bulge usually does not cause any bruising, cuts, or redness on the skin. The size of the bulge can vary, sometimes being more noticeable than others. Initially, the bump will feel soft, but as the blood inside begins to harden, it will become firmer. Over time, the bulge will start to shrink, with the center typically dissolving before the outer edges, giving it a "crater-like" appearance. This is a positive indication that the healing process is progressing well. In addition to the external bulge, newborns with cephalohematoma may experience internal symptoms.

Causes of Cephalohematoma

Cephalohematoma in newborns typically occurs during labor or delivery, sometimes appearing hours or days after birth. It is caused by pressure or trauma to the infant's head, leading to the tearing of blood vessels on the scalp. The specific factors that contribute to head trauma during delivery can vary.

One common trigger is when the baby's head makes contact with the mother's pelvic bone while moving through the birth canal. This impact, combined with the force of contractions, can result in a cephalohematoma.

Another frequent cause of birth-related head trauma is the use of medical devices like vacuum extractors and obstetrical forceps. These instruments assist in delivery when the mother's contractions are insufficient to propel the baby through the birth canal. However, the pressure applied by these devices can be strong enough to cause blood vessel rupture on the baby's head.

Overall, cephalohematoma is a condition that warrants attention and understanding, especially in the context of childbirth and potential causes of head trauma during delivery.

Diagnosis of Cephalohematoma

Your doctor will perform a thorough physical examination of your newborn right after delivery and during the first pediatrician visit within 1-3 days. Sometimes, a bulge may be sufficient for diagnosis, but additional tests such as 

X-ray,

CT scan,

MRI scan, or ultrasound may be requested by the doctor when needed.

Newborn Cephalohematoma Prognosis

Newborn babies diagnosed with newborn cephalohematoma can usually recover within a few months when given proper treatment. Most cephalohematomas heal on their own without causing long-term physical or developmental issues.

Typically, the center of the hematoma will start to shrink first, while the outer edge may become hardened due to calcium deposits.

Early detection and treatment of newborn cephalohematomas can help prevent or reduce complications. Failure of healthcare providers to promptly address the signs of an infant hematoma could be considered medical malpractice.

Get Help for Newborn Cephalohematoma from NJPNI

Having a newborn with a bruised-looking lump on their scalp can be worrying, but cephalohematomas are usually harmless. This lump tends to decrease in size and disappear on its own within a few weeks or months without needing any treatment. Your baby's healthcare provider will monitor the bump during their check-ups. Cephalohematomas can slightly raise the risk of jaundice, anemia, and infections in babies. In rare cases, a newborn may have a skull fracture, which typically heals naturally. If your baby is very irritable, displays signs of jaundice, or has trouble eating or sleeping, it's best to contact your healthcare provider promptly.