A cephalohematoma is a collection of blood between a newborn’s scalp and the underlying skull bone. It forms when tiny blood vessels rupture, causing blood to pool beneath the periosteum, the membrane covering the bone. Though a soft bulge on a baby’s head can be concerning, cephalohematomas are common and typically benign.
Understanding Cephalohematoma
Cephalohematomas often occur due to pressure on a baby’s head during childbirth, especially during prolonged or difficult vaginal deliveries. Assistive devices like vacuum extractors or forceps can also contribute to vessel rupture. The blood collection is confined to a single skull bone because the periosteum, a tough membrane, is tightly attached at the bone’s suture lines. This distinguishes it from caput succedaneum, a head swelling that involves fluid above the periosteum and can cross suture lines. A cephalohematoma does not involve bleeding within the brain itself, so it does not impact brain development or function.
Typical Resolution Timeline
Cephalohematomas resolve gradually, typically over several weeks to a few months, as the body slowly reabsorbs the blood clot. While some may diminish within the first month, others can take up to six months or longer to fully disappear. As the blood reabsorbs, the initial soft bulge may feel firmer, and the center might flatten before the edges, creating a “crater-like” appearance. This change in texture and shape is a normal part of the healing process.
Factors Influencing Resolution
Several factors can influence how long it takes for a cephalohematoma to resolve. The size of the blood collection is a significant determinant; larger cephalohematomas generally require more time for the body to reabsorb the pooled blood. If a cephalohematoma persists for more than five weeks, calcium deposits can form around the mass, leading to calcification. Calcified cephalohematomas may take longer to resolve and can sometimes result in a persistent hard bump, though spontaneous resolution of calcified areas can still occur. The individual infant’s healing capabilities and overall health also play a role in the speed of resolution.
Monitoring and When to Seek Medical Advice
Parents should observe the cephalohematoma for changes in size, shape, and texture as part of routine care. Regular check-ups with a pediatrician are important to monitor its progression and ensure it is resolving as expected. While most cephalohematomas resolve without complications, certain signs warrant immediate medical attention:
Signs of infection, such as increasing redness, warmth, swelling, pus, or fever.
An increase in the cephalohematoma’s size after the first few days.
Unusual fussiness, lethargy, feeding difficulties, or a high-pitched cry.
Signs of jaundice, such as yellowing of the skin or eyes, as blood breakdown can lead to elevated bilirubin levels.