What to Know About Babies and Cephalohematomas

cradling baby head
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Some newborns develop a soft bump, often with a boggy feeling, on their head shortly after birth, which is called a cephalohematoma. Because some cephalohematomas are quite noticeable, it’s understandable that you’d feel stressed and upset. Even the most minor and innocuous difference can worry a new parent, especially if it’s something you were not prepared for or that looks concerning.

Thankfully, while concerning in appearance, cephalohematomas usually resolve on their own. And while cephalohematomas need to be monitored, they generally do not cause any harmful effects for your baby, nor do they have long-term health consequences.

What Is a Cephalohematoma?

Simply put, a cephalohematoma is an accumulation of blood under the scalp. During the birth process, small blood vessels crossing the thin layer of tissue just above the skull bones are torn, allowing blood to gather on top of the skull bone and under this tissue layer.

Because the cephalohematoma is a collection of blood on top of the skull, there is no pressure on or bleeding into or around the baby's brain since the brain sits under the skull bones. Cephalohematomas do not affect your baby's brain.

The bleeding is gradual and usually takes several hours or days after birth for the cephalohematoma to form. Because the mass forms on top of the skull, there is no concern about bleeding into or around your baby’s brain.

Though rare, cephalohematomas are one of the most common birth injuries, occurring in about 0.4%–2.5% of all births. They are more likely to occur in male babies, and in births that included interventions such as forceps delivery.

They are also more common in larger babies, babies of first time moms, and babies who are malpositioned in the birth canal, such as head down, but back-facing (also known as “sunny-side up” babies).

Symptoms of Cephalohematomas

The most prominent symptom of a cephalohematoma is a soft bump or bulge on your baby’s head. Generally, the bump is skin colored and not bruised or reddened. Cephalohematoma can vary in size—some will be obvious to most onlookers, and some will be less so (though usually a baby’s observant and concerned parent will notice it!).

As your baby’s cephalohematoma begins to resolve—a process which takes several weeks—you may notice it change in texture and appearance. What likely started off feeling boggy might turn into a firm bulge as the blood calcifies. Rest assured, this is just part of the healing process.

You may notice that the center of the bump begins to dissipate before the outer edges do. Some parents say in this stage in resolution, the bump has a “crater-like” look to it. This is normal as well, and is another sign that your baby’s cephalohematoma is in the process of resolving.

Besides the obvious bulge, sometimes cephalohematomas have complications, as they can cause newborn jaundice. In rarer cases, they may cause anemia or infection.

Causes

Newborn cephalohematomas usually occur during the birth process—although it may take several hours or days for them to present themselves after birth. Any sort of intense pressure on your newborn’s scalp during the birthing process can cause the blood vessels in their periosteum (the thin layer of tissue just above the skull bones) to burst, causing a cephalohematoma. The most common causes of birth related cephalohematomas include:

  • Forceps delivery
  • Vacuum assisted delivery
  • Long labors
  • Lengthy second stage of labor
  • Macrosomia (babies born with unusually large heads, which can make vaginal birth more difficult)
  • Malpositioning in the birth canal (breech birth, “sunny-side up” birth)
  • Weak uterine contractions, which prolong labor
  • Multiple gestation birth (twins, or more)

Diagnosis

Usually your baby’s cephalohematoma will be diagnosed by discharge at your hospital, but sometimes your baby’s pediatrician will diagnose it at a later date. However, cephalohematoma will not generally prolong your hospital stay. You will likely be discharged with instructions to keep watch over your baby’s cephalohematoma and discuss it with your pediatrician.

Once your doctor suspects that the bulge on your baby’s head is a cephalohematoma, they may ask you a series of questions, including what your labor and delivery was like, and what interventions were used. Then, your doctor will do a complete physical of your baby to rule out any other medical issues or causes of the bump.

Usually, a physical inspection is all that’s required to diagnose a cephalohematoma. However, in rare cases, your doctor may suspect something else is the cause of the bump and may want to perform other diagnostic evaluations—especially if other symptoms are present beside the bulge.

Neurological, respiratory, or cardiovascular symptoms may warrant further testing. These tests include:

  • X-rays
  • CT scans
  • Ultrasound

Risks and Complications

Most of the time, cephalohematomas are just an appearance issue. Most parents don’t like how they look, but they pose no danger to babies, and resolve on their own.

They do not hurt your baby - they do not cause physical pain to the baby, nor do they harm the baby's brain or any other part of their body. And, they don’t affect your baby’s brain development, because they occur outside of your baby’s protective skull. They also do not pose any long-term physical or developmental dangers.

However, in rare cases, a cephalohematoma may increase your baby’s risk of developing newborn jaundice.

Newborn Jaundice

If the bleeding in your baby’s cephalohematoma is significant, your baby may develop jaundice as a result of the breakdown of red blood cells that happen after the cephalohematoma develops.

What Is Jaundice?

When cells die they are broken down and bilirubin is created in the breakdown process. Because red blood cells are not yellow, bilirubin is not present in live red blood cells. But when cells can’t break it down sufficiently, bilirubin builds up in the body, resulting in a yellowish appearance to the skin, along with other physical manifestations, such as poor feeding and lethargy.

Newborns are particularly prone to jaundice because their livers are not yet efficient at breaking down bilirubin. If your baby has a cephalohematoma, your doctor will likely ask you to monitor your baby for signs of jaundice. Here is what to look for in your baby:

  • Yellowish color to the skin
  • Yellowish color to the white of the eyes
  • Lethargy (hard to rouse)
  • Feeding difficulty
  • High-pitched crying

You should bring your baby into the doctor if you notice any signs of jaundice. Your doctor will likely check your baby’s bilirubin levels. If your baby has jaundice, they will probably need prompt treatment.

Most jaundice treatment is non-invasive and involves blue light phototherapy. Jaundice needs to be addressed as soon as signs emerge; if untreated, it can cause brain damage.

Treatment

Unless there are additional complications such as jaundice, most doctors will take a hands-off approach to cephalohematoma. However, it is necessary to monitor the condition.

Your doctor will likely ask you to monitor the appearance of the cephalohematoma and watch for any other unusual symptoms in your baby. Usually the child is seen for their well child visits - and doesn't need additional visits for a cephalohematoma.

Draining cephalohematomas is not recommended because the blood has already clotted. Plus, aspiration has an increased risk of infection and abscess formation. The best way to treat a cephalohematoma is to leave it alone and allow the body time to reabsorb the collected fluid.

Do Cephalohematomas Disappear?

Yes, in almost all cases, cephalohematomas resolve on their own. It can take 2 weeks to 3 months for the resolution to be complete. Again, it is not considered safe to drain or otherwise remove cephalohematomas, but time and a little patience go a long way.

What Is the Long-Term Outlook?

Cephalohematomas may look concerning and you may naturally feel concerned about what it means for your baby to develop one. But cephalohematomas are “skin deep” issues, and do not impact your baby’s body as a whole, nor do they affect your baby’s brain.

Jaundice, if it does occur, is time-limited and only a concern in the newborn period. There are no known long-term complications of being born with a cephalohematoma, and within a few weeks or months, your baby’s cephalohematoma will be long forgotten.

A Word From Verywell

Because of the dramatic appearance of some larger cephalohematomas, it’s reasonable that parents might feel quite concerned. After all, it’s our instincts as parents to worry over every little bump, bruise, or abnormality our baby develops.

Even after you’ve been given every reassurance that your baby’s cephalohematoma is nothing to be concerned about, you may still feel a nagging sense of worry about it.

If you have any questions—large or small—you should definitely bring them to your child’s pediatrician. That’s what they are there for. You can prepare a list of questions you have before your visit so you will be able to ensure that all of your questions are addressed.

Of course, even though cephalohematomas are largely innocuous, they can cause jaundice, so you should monitor your baby for any signs of jaundice including yellowing skin, lethargy, and poor feeding. Don’t hesitate to call your doctor if you encounter any of these—or any other concerning symptoms.

Always trust your parental instincts when it comes to your baby, and report any issues you observe to your doctor. Most cephalohematomas resolve in a matter of weeks, so however stressful this may be to your right now, before you know it, that funny little bump on your baby’s head will be a distant memory.

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3 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Academy of Pediatrics. Your baby's head. Updated June 1, 2010.

  2. National Center for Biotechnology Information, U.S. National Library of Medicine. Cephalohematoma. Updated December 15, 2020. PMID:29262234

  3. Stanford Children's Health. Birth injuries.

Additional Reading
  • Birth Injuries. Stanford Children’s Health website. Updated August 24, 2020.

  • Osaghae DO, Sule G, Benka-Coker J. Cephalhematoma causing severe anemia in the newborn: report of 2 cases. Annals of Medical Health & Science Research. 2011;1(2):223-226.

  • Raines DA, Krawiec C, Jain S. Cephalohematoma. Treasure Island, FL: StatPearls Publishing; 2020. Updated August 13, 2020.