Infant Cephalohematoma

Trauma during labor and delivery can cause cephalohematoma, or damage to blood vessels on the skull.

Infant cephalohematoma is a medical condition that occurs in 1-2 percent of all live births. This condition is more likely to happen if birth-assisting tools are used during delivery; such as forceps or vacuum extraction. If forceps or a vacuum were used; the rate of cephalohematoma increases to 3-4 percent. 

Although it is considered a minor injury; that usually heals without any major medical problems, there are certain factors related to cephalohematoma that may lead to additional complications.

What is Infant Cephalohematoma?

Cephalohematoma is a traumatic subperiosteal hematoma that occurs underneath the skin, above the periosteum of the infant’s skull. The periosteum is a layer of connective tissue that surrounds skull bone. 

infant cephalohematoma image brain description

Cephalohematoma does not pose any risk to brain cells, but it causes unnecessary pooling of blood from damaged blood vessels between the skull and inner layers of the skin. Cephalohematomas are not usually evident at birth but develop during the hours and days following birth due to the gradual nature of the blood accumulation.

What Causes Cephalohematoma?

Cephalohematoma generally occurs during labor and delivery. It often occurs as a result of difficult or prolonged labor. Medical research links the use of forceps during delivery with a heightened risk of Cephalohematoma.  This is especially true when the healthcare provider applies excessive force to the infant’s head during delivery.

what causes cephalohematoma according to UBBM Medica Network

Is There A Way To Prevent Cephalohematoma?

The best way to prevent cephalohematoma is to recognize possible risk factors and adjust prenatal care accordingly. Some of the primary risk factors for cephalohematoma include:

  • The infant’s head is larger than the mother’s pelvic area
  • Weak or ineffective uterine contractions
  • Difficult, prolonged labor
  • Abnormal fetal presentation
  • Multiples

What are the Symptoms of Infant Cephalohematoma?

Cephalohematoma is mostly internal, so it’s not as easy to see as a laceration, and infants may not react with obvious behavioral symptoms. 

signs of cephalohematoma, bulge in baby's head

Less common, but relevant symptoms that a doctor can diagnose include:

  • Anemia
  • Infection
  • Jaundice

If you find an unnatural bulge on the baby’s head; your physician should check it out immediately.

Cephalohematoma Treatment

The first and most important step is: to get your baby examined by a doctor. Your doctor can guide you on the best way to handle your child’s cephalohematoma.  Some cases require treatment, and others resolve on their own over time.

In most instances, infants will heal on their own within three months. However, hardening of the hematoma can occur causing significant deformities of the skull. Other complications include infection that can lead to sepsis or osteomyelitis.  These complications are very rare, but you should be aware that they can happen. 

In cases where the blood build-up is so excessive that it lowers the baby’s red blood cell count, a blood transfusion may become necessary.

Infants with cephalohematoma are also at a heightened risk for developing jaundice, because as the blood cells break down the levels of bilirubin increase. In these instances, and if the bilirubin is excessively high, treatment may include phototherapy.

jaundice description, bilirubin buildup

Cephalohematoma Prognosis

Although most infants with cephalohematoma will heal on their own, it’s important to monitor and observe your child. Keep a close eye on any additional bulging or signs of jaundice. Also, keep an eye out for behavioral changes.

what to monitor in your child for cephalohematoma

As long as your child is healing, the prognosis for cephalohematoma is generally very good. The key is keeping your healthcare provider informed of any changes in your child’s health or behavior.

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Kimberly Langdon

Page Medically Reviewed By Kim Langdon, M.D.

Kimberly Langdon, M.D. is a retired board-certified OB/GYN with 19 years of clinical experience. She currently works as a medical writer and featured healthcare expert. She is a regular medical reviewer for Birth Injury Guide.

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