Parents may notice swelling on their newborn’s head, which can cause concern. Caput succedaneum is a common, temporary, and generally harmless condition responsible for this swelling. This article explains caput succedaneum, its origins, what to expect, and how it differs from other types of head swellings.
What is Caput Succedaneum?
Caput succedaneum is localized swelling or edema that often appears on a newborn’s scalp immediately following a vaginal delivery. It presents as a soft, spongy, or puffy spot on the baby’s head, typically affecting the part that emerged first through the birth canal. This swelling involves fluid collection within the scalp tissue, specifically above the periosteum, the membrane covering the skull bones.
The swelling is diffuse and can extend across the cranial suture lines, the fibrous joints connecting the skull bones. The affected area might also show some bruising or a bluish discoloration. This condition affects the soft tissues of the scalp and does not involve injury to the skull bones or the brain itself.
How Does It Happen?
Caput succedaneum develops due to pressure on the baby’s head during birth. As the infant navigates the narrow birth canal, sustained pressure from the mother’s uterus, cervix, or vaginal walls can cause fluid to accumulate in the scalp’s soft tissues. This pressure temporarily obstructs blood and lymph flow from the compressed area, leading to fluid accumulation.
Factors increasing the likelihood include prolonged labor, where the baby’s head is subjected to extended pressure. The use of assisted delivery tools such as vacuum extractors or forceps can also intensify scalp pressure. In some instances, caput succedaneum can develop before labor if the amniotic sac ruptures prematurely, removing the cushioning fluid around the baby’s head.
What to Expect and How It’s Managed
Caput succedaneum is a harmless condition that resolves on its own without specific medical intervention. The swelling typically decreases within a few days after birth, with most cases resolving completely within 48 to 72 hours, or up to a week. As the fluid is reabsorbed by the baby’s body, the scalp gradually returns to its normal appearance and shape.
Parents should handle the baby’s head gently and keep the area clean. Avoid applying pressure or attempting to drain the swollen area, as this could introduce infection. While caput succedaneum usually has no long-term effects, associated bruising can sometimes contribute to newborn jaundice, which occurs due to the breakdown of red blood cells. Jaundice is typically managed with phototherapy or increased feedings, and most cases resolve without complications.
Is It Different from Other Head Swellings?
Newborn head swellings can be confused, but caput succedaneum has distinct characteristics that differentiate it from other conditions, particularly a cephalohematoma. Caput succedaneum is a soft tissue swelling of the scalp present at birth that readily crosses the cranial suture lines. It feels soft and often appears bruised, with poorly defined margins.
In contrast, a cephalohematoma (ICD-10 code P12.0) is a collection of blood that forms between the skull bone and its outer covering, the periosteum. Unlike caput succedaneum, a cephalohematoma does not cross the suture lines, confining it to a single skull bone. It may not be immediately apparent at birth, often appearing hours or a day later, and typically feels firmer to the touch. Cephalohematomas also take longer to resolve, sometimes weeks or months, as the blood collection needs to be reabsorbed by the body.