What to Know About Babies and Cephalohematomas

cradling baby head
Catherine Delahaye / Getty Images.

If your baby is born with any kind of abnormality, 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.

A cephalohematoma is a soft bump on a newborn’s head that develops shortly after birth. Some cephalohematomas can be quite noticeable.

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 formed as a result of an accumulation of blood between the baby’s skull and scalp. Usually, blood vessels are ruptured as a result of a birth injury.

Because the bleeding is gradual, it 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 appearance. As the blood calcifies, the bulge may feel firmer. 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 scalp skin 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:

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, and don’t affect your baby’s brain development, because they occur outside of your baby’s protective skull. They 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. Even less commonly, a cephalohematoma may increase your baby’s risk of anemia.

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?

Jaundice is caused by the buildup of bilirubin—the yellow pigment in red blood cells. When your cells can’t break it down sufficiently, it builds up in your body, resulting in a yellowish appearance to the skin, along with other physical manifestations, such as fatigue 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
  • As jaundice becomes more developed, your baby may develop a fever

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.

Anemia

While less heavily documented, there have been cases of cephalohematoma causing anemia to develop in babies. For example, the Annals of Medical and Health Sciences Research journal presents two cases studies of babies who developed severe anemia as a result of cephalohematomas.

Cephalohematoma is thought to cause anemia because of blood loss, especially when the cephalohematoma is large in size. In rare cases, a blood transfusion may be necessary to reverse the anemia caused by cephalohematoma.

Treatment

Unless there are additional complications such as jaundice or anemia, 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. Your doctor will also likely ask you to come in for periodic evaluations until the cephalohematoma resolves.

Although some doctors do elect to drain cephalohematomas, this practice is usually not recommended as it has an increased risk of infection.

Do Cephalohematomas Disappear on Their Own?

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 for Cephalohematoma?

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. Any complications—such as jaundice or anemia—are time-limited and only concern 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 cephalohematoma are largely innocuous, there are some possible complications, so you should monitor your baby for any signs of 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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Article 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.
  • 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.