Does your newborn baby have a lump on his head? Could it be a cephalohematoma? Let's talk about it!

When you look at your newborn baby with interest, sometimes you notice a small bump on the baby's head. It's very normal to feel a little scared and worried when you see it. As a mother or father, it's no wonder that you feel that way. But most of the time, this is not something to be afraid of. Today, we're going to talk about something that is very important for you to know at a time like this.

What is this cephalohematoma?

Simply put, a cephalohematoma is a collection of blood between the skin and the skull of a newborn baby. Imagine, when a baby comes into this world, that is, during childbirth, there is a slight push and pressure on the baby's head. At that time, the small blood vessels in the skin of the head are damaged, sometimes they break, and that blood can collect under the skin of the head, on top of the skull. 'Hematoma' is the accumulation of blood outside such blood vessels. The word 'cephalo' means something related to the head. So, this accumulation of blood is what causes a soft lump on the head. After a while, this lump can become a little hard.

How common is this condition?

In fact, this condition called cephalohematoma is not that common. According to statistics, about 2.5% of babies who have prolonged, difficult vaginal deliveries, or about two to three babies out of every 100, may develop this condition. However, if a vacuum extraction device or forceps is used to assist in the delivery, the chance of developing this condition is slightly higher , about one in 10 babies who have such devices.

What are the risk factors for developing cephalohematoma?

There are several factors that can contribute to your little one developing a cephalohematoma. Let's take a look at what they are so you can have a better understanding of this:

• Assisting with labor: Using a vacuum extraction or forceps during labor. These devices put pressure on the baby's head, which can sometimes damage delicate blood vessels.
• Epidural painkillers: Epidurals, which are given to reduce pain during childbirth, have also been found to be a cause in some cases.
• A larger-than-normal baby: If your baby weighs more than 4 kilograms (8 pounds and 13 ounces), a condition medically known as fetal macrosomia , there may be more pressure on the baby's head as it emerges.
• Twins or more: If there are multiple babies (twins or triplets ) in one womb, this condition can occur due to limited space in the womb during delivery and the nature of the delivery.
• Prolonged or difficult labor: If a normal vaginal delivery takes longer than expected or if the labor is difficult, this risk exists because the baby's head may be under pressure for a longer period of time.

What does a baby with a cephalohematoma look like? What are the symptoms?

When pressure is applied to the skin of the baby's head during childbirth, tiny blood vessels in the skin can be damaged or burst. When this happens, blood collects under the skin of the head, above the skull bone, and forms a soft lump or swelling . This is most often seen at the back of the head .

This lump can appear very soon after birth, sometimes within a few hours. Sometimes it can grow slightly over the first few days. It can look like a bruise, with a bluish-green color .

Over time, the soft lump will gradually harden, as if it were calcified . This means it will become like a rock. Often, the center of the lump will shrink first, so it may take on a ring-shaped or crater-like appearance. This can be a bit scary for parents to see, but it is a normal process.

What happens if my baby has a cephalohematoma? Should I be worried?

Now you're probably thinking, "What if something like this happens to my baby? Is this dangerous?" To be honest, most of the time, this cephalohematoma is harmless and not something to be too worried about .

The bruise-like blood clot will heal and disappear on its own in a few weeks, or maybe two or three months, without any special treatment .

Your baby's pediatrician will pay close attention to this lump when examining your baby. So don't worry too much. Sometimes the doctor will tell you not to press on the lump and to let it heal on its own.

What are the possible complications of cephalohematoma?

Although usually harmless, in very rare cases, cephalohematoma can cause some complications. It is important to be aware of these as well.

• Anemia: When a cephalohematoma forms, which is when blood collects in the head, some of the baby's circulatory system moves to the lump. This can cause the baby to develop anemia, a condition in which the number of red blood cells is low . The larger the lump, the higher the risk of developing this anemia.
• Calcifications: Sometimes, if the lump has been there for more than five weeks, hard, bone-like deposits (calcifications) can form around it. This is very rare. However, if this happens, it can affect the shape of the skull, so you may need to have corrective surgery to remove the calcium deposits. However, this is very rare.
• Infections: A cephalohematoma is slightly more likely to develop infections than normal skin. Very rarely, serious infections such as osteomyelitis, cellulitis, or sepsis, which can be life-threatening, can occur. But, again, these are very rare.
• Jaundice: As the blood in the cephalohematoma slowly seeps into the baby's body, the red blood cells in that blood break down, producing a yellow substance called bilirubin . When the level of bilirubin in the blood increases, jaundice can develop. The baby's skin and eyes may appear yellow.
• Skull fractures: It has been found that about one in four babies (about 25%) with cephalohematoma may also have a linear skull fracture . While this may sound scary, this type of fracture does not cause the bones of the skull to move, meaning they are not displaced. Therefore , it will heal on its own over time without any special treatment .

What is the difference between Cephalohematoma and Caput Succedaneum?

You may have heard of 'Caput Succedaneum'. Some people call it 'caput' for short. You may have also seen a newborn baby's head appear slightly elongated like a cone, which is also called this name. Cephalohematoma and Caput Succedaneum can occur together or separately. However, both usually resolve without any special treatment.

Now let's see what the main differences are between the two, so you can understand them without getting them confused:

• Cephalohematoma:
• This is a collection of blood (hemorrhage) under the skin of a newborn baby's head .
• This is what happens right after the baby is born, maybe a few hours later.
• The knot is well separated, and the boundaries are clearly visible .
• The most important thing is that this knot does not cross the suture lines that connect the bones of the skull to each other . That is, it is limited to one bone.
• Most often, it is located at the back of the head (parietal or occipital bones) .
• It can take a few weeks to a few months for this to fully heal.

• Caput Succedaneum:
• This is caused by swelling of the skin on the scalp (edema) , which is a buildup of fluid between the tissues. It is not a buildup of blood.
• This swelling can be seen as soon as the baby is born.
• The swelling makes the scalp feel like a sponge and is squeezable .
• This swelling can spread across the entire skull, past the suture lines .
• This goes away quickly, within a few days , not long after the baby is born.

So, it will be useful for you to be aware of these changes.

Finally, take-home message

It's normal for a parent to feel scared and worried when they see something like a bruise or lump on their newborn's head. But cephalohematoma is usually harmless and heals on its own .

This lump will shrink, become scaly, and disappear without any special treatment within a few weeks, sometimes months . Your baby's pediatrician will keep an eye on this lump each time he sees your baby, to see if it is getting smaller.

However, as we have discussed before, there is a small risk of jaundice, anemia, and very rarely infections in the baby due to cephalohematoma. Also, some babies may have a skull fracture, but that too will heal on its own.

If your baby seems to be in distress, crying a lot (extreme fussiness), showing signs of jaundice (yellowing of the skin and eyes), refusing to eat, or refusing to sleep properly , definitely make an appointment with your doctor for advice.

Remember, if you have any questions or concerns about your baby, it's always best to consult a doctor. Things you find online may not always be right for your baby. So don't worry, most of the time these are things that can be easily solved!

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