What is a cephalohematoma?

What you need to know about the lump on your baby’s head

A cephalohematoma is a blood clot that occurs between the skull and the scalp as a result of ruptured blood vessels. Cephalo- means “head” or “skull,” and hematoma describes internal bleeding, usually clotted.

Newborn cephalohematomas can be caused by prolonged labor, or a difficult vaginal birth. Cephalohematomas usually happen at the same time as other types of birth trauma such as caput succedaneum (head swelling), and are often associated with the use of birth-assisting tools such as forceps or vacuum extractors. Newborn cephalohematomas usually heal without any major medical intervention, but if improperly treated, the consequences can be serious.

Identifying newborn cephalohematomas

Usually, a cephalohematoma looks like a raised bump on a baby’s head. The bump typically appears several hours to a day after birth and is often largest on the second or third day. By that time, the internal bleeding typically stops. The cephalohematoma may initially be soft, but get firmer over time.

Often, appearance alone is enough to diagnose a cephalohematoma. However, doctors may order an X-ray, CT scan, MRI scan, or ultrasound to verify.

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What causes newborn cephalohematomas?

Any type of trauma to the baby’s head can potentially cause a cephalohematoma. More specific examples include the following:

• Prolonged or difficult delivery
  • Cephalopelvic disproportion (CPD) describes a situation where the baby’s head is larger than the mother’s pelvic opening. This can prolong delivery and/or make it difficult for the baby’s head to safely leave the mother’s pelvis.
  • Fetal macrosomia occurs when the baby is larger than is expected for gestational age. This may also increase the risk of trauma to the baby’s head during delivery.
• Abnormal fetal position
• Birth of multiples (twins, triplets, or more)
• Use of forceps or vacuum extractors: These assistive delivery tools can increase the risk of not only cephalohematomas, but many other problems, including permanent brain injury. They must be used only by very experienced medical professionals, and only under a strict set of circumstances.

Are newborn cephalohematomas common?

According to the Cleveland Clinic, cephalohematomas are present in 2.5% of difficult and prolonged vaginal deliveries. A doctor that uses forceps or a vacuum extractor to deliver a baby increases the risk of cephalohematoma and other injuries.

Treatment

In most instances, cephalohematomas go away on their own without any major medical intervention. However, babies with cephalohematomas should be carefully monitored. Sometimes, a doctor may attempt to drain or aspirate the blood, but this is generally not advised because it increases the risk of infection and abscess. However, if a cephalohematoma becomes infected or abscessed, draining it may then be necessary (along with antibiotic treatment). Doctors must manage infections of cephalohematomas very carefully, as they can lead to meningitis (infection of the brain).

Although cephalohematomas are generally not a major threat, they can increase the risk of health complications such as anemia and jaundice.

If a baby develops anemia, they may require a blood transfusion. Like cephalohematomas, jaundice may only be a mild issue, and it is easily treatable . However, babies with jaundice should be closely monitored. If jaundice becomes severe and doctors fail to provide appropriate treatment, it can result in cerebral palsy (CP), hearing loss, and other permanent disabilities.

Legal Help for Birth Injuries

Complications from a cephalohematoma are preventable. If a doctor or hospital mismanages a baby’s cephalohematoma and it leads to permanent injury, that is considered medical malpractice. As a parent, it can be frustrating to learn that the people you trusted with your baby’s care made a mistake, but you do have legal options. 

When choosing a firm, it’s critical that parents and caregivers put their trust in a team that is experienced in complex birth injury law and committed to giving their clients the best results possible. Birth injury cases can take years to complete. Our firm exclusively handles birth trauma cases to give each client the attention their case deserves.

For over 25 years, we have worked with parents like you to create a more secure future for children with birth injuries. We know it can be intimidating to speak to a lawyer about your child’s birth or even consider filing a lawsuit. That’s why our team provides free and compassionate consultations to discuss your potential case and answer any questions you may have – without any obligation to pursue a case. 

We understand how difficult it can be to find free time as a parent, let alone a parent caring for an injured child. Our team is here to patiently listen at a time convenient for you – absolutely free. In fact, our clients pay nothing unless we recover a favorable settlement or verdict for their family.

Sources

1. Perry, S. E., Hockenberry, M. J., Lowdermilk, D. L., & Wilson, D. (2013). Maternal child nursing care. Elsevier Health Sciences.

2. Healthline: Cephalohematoma: Causes, Outlook, and More

3. Neonatal Jaundice Treatment & Management: Approach Considerations, Medical Care, Diet. (2018, July 25). Retrieved September 13, 2023, from https://emedicine.medscape.com/article/974786-treatment#d6

4. Shorofsky, M. J., & Bhatia, D. (2018). Newborn with spontaneous rupture of an infected cephalohematoma. International Journal of Contemporary Pediatrics, 5(2), 649-650.

5. Cleveland Clinic: Cephalohematoma