A caput succedaneum is a type of swelling around the skull, which can give an infant a “conehead” appearance (1). Usually, it forms after a difficult delivery. The caput succedaneum will typically disappear within a few days, but if bruising is involved, the infant may develop jaundice. If left untreated, this can lead to more serious problems (2). Sometimes, they may also have a “halo scalp ring” pattern of alopecia (baldness) or infection (3).
Causes and risk factors for caput succedaneum
A prolonged delivery with excessive pressure on the baby’s head can cause swelling and bruising. Additionally, a caput succedaneum is more likely to form in deliveries with the following complications/characteristics:
- Premature rupture of membranes (PROM)
- Oligohydramnios (insufficient amniotic fluid)
- Vacuum extractors or forceps use (2)
- Braxton Hicks contractions
- Primiparous mother (first time giving birth) (4)
Signs and diagnosis of caput succedaneum
A caput succedaneum is usually most obvious immediately after delivery. Medical professionals should recognize it as a soft swelling of the scalp, primarily on the part of the head which came through the birth canal first, although it may extend to both sides of the scalp. It is typically 1-2 cm in depth. There may be bruising or changes to the color of the skin (2, 5).
Treatment and long-term outcomes for babies with caput succedaneum
In most cases, no treatment is needed for a caput succedaneum; it will likely go away on its own. However, if there is bruising involved, this may lead to elevated bilirubin and jaundice (6). Jaundice is usually not a serious threat either, and in a mild form, often resolves spontaneously. Sometimes jaundice does require treatment, which may include phototherapy, blood transfusions, or addressing any underlying causes (7). If more intense degrees of jaundice go undiagnosed or are improperly managed, this can result in kernicterus, which is a dangerous and permanent form of brain damage. Babies with kernicterus may develop cerebral palsy, hearing impairments, and other lifelong disabilities (6).
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1. Bronfin, D. R. (2001). Misshapen heads in babies: position or pathology?. The Ochsner Journal, 3(4), 191-199.
2. Caput succedaneum: MedlinePlus Medical Encyclopedia. (n.d.). Retrieved August 31, 2018, from https://medlineplus.gov/ency/article/001587.htm
3. (n.d.). Retrieved August 31, 2018, from https://www.uptodate.com/contents/neonatal-birth-injuries#H8
4. CRNP, L. S. (n.d.). Caput succedaneum: Symptoms, causes, and outlook. Retrieved August 31, 2018, from https://www.medicalnewstoday.com/articles/318918.php
5. Nicholson, L. (2007, September/October). Caput Succedaneum and Cephalohematoma: The Cs that Leave Bumps on the Head[PDF]. Neonatal Network.
6. CRNP, L. S. (n.d.). Caput succedaneum: Symptoms, causes, and outlook. Retrieved August 31, 2018, from https://www.medicalnewstoday.com/articles/318918.php
7. Neonatal Jaundice Treatment & Management: Approach Considerations, Medical Care, Diet. (2018, July 25). Retrieved August 31, 2018, from https://emedicine.medscape.com/article/974786-treatment#d6